Provider Demographics
NPI:1538439419
Name:GAVINS, GREER SMITH (FNP)
Entity type:Individual
Prefix:
First Name:GREER
Middle Name:SMITH
Last Name:GAVINS
Suffix:
Gender:F
Credentials:FNP
Other - Prefix:
Other - First Name:GREER
Other - Middle Name:MONIQUE
Other - Last Name:SMITH
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:FNP
Mailing Address - Street 1:10801 LOCKWOOD DR
Mailing Address - Street 2:SUITE 230
Mailing Address - City:SILVER SPRING
Mailing Address - State:MD
Mailing Address - Zip Code:20901-1556
Mailing Address - Country:US
Mailing Address - Phone:301-593-3424
Mailing Address - Fax:301-593-3644
Practice Address - Street 1:10801 LOCKWOOD DR
Practice Address - Street 2:SUITE 230
Practice Address - City:SILVER SPRING
Practice Address - State:MD
Practice Address - Zip Code:20901-1556
Practice Address - Country:US
Practice Address - Phone:301-593-3424
Practice Address - Fax:301-593-3644
Is Sole Proprietor?:No
Enumeration Date:2012-01-09
Last Update Date:2013-11-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LAAP0642363LF0000X
MDR205014363LP0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPediatrics
No363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily