Provider Demographics
NPI:1386524791
Name:SMALLIN, GRETA DIANE (RN)
Entity type:Individual
Prefix:
First Name:GRETA
Middle Name:DIANE
Last Name:SMALLIN
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:865 FAGAN RD
Mailing Address - Street 2:
Mailing Address - City:SNYDER
Mailing Address - State:TX
Mailing Address - Zip Code:79549-9384
Mailing Address - Country:US
Mailing Address - Phone:806-577-9969
Mailing Address - Fax:
Practice Address - Street 1:865 FAGAN RD
Practice Address - Street 2:
Practice Address - City:SNYDER
Practice Address - State:TX
Practice Address - Zip Code:79549-9384
Practice Address - Country:US
Practice Address - Phone:806-577-9969
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-09-05
Last Update Date:2025-09-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX596917163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse