Greene, Jacquelin London
Greene, Jacquelin London is an individual health care provider with primary practice located at 58 Carroll St , Lebanon VA 24266. She recently has only one registered license in Physician Assistants & Advanced Practice Nursing Providers / Family, which is considered as her primary health care specialty. Greene, Jacquelin London can be contacted via phone (276) 883-8086.Contact Information
Primary practice address
58 Carroll St
Lebanon VA 24266
Phone: (276) 883-8086
Fax: (276) 883-8090
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Physician Assistants & Advanced Practice Nursing Providers / Family | 363LF0000X | 0024168638 | Virginia |
| Physician Assistants & Advanced Practice Nursing Providers / Family | 363LF0000X | 14888 | Tennessee |
Profile Details
| NPI number | 1124002035 |
|---|---|
| LBN Legal business name | Greene, Jacquelin London |
| Credentials | FNP-C |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Dec 5th, 2005 |
| Last updated | Feb 7th, 2017 - about 8 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1124002035 | NPPES |
| Virginia | MEDICAID | 1124002035 | |
| Virginia | Other | 0024168638 | |
| Virginia | MEDICAID | Q003735 |
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