Greene, Jacquelyn Nicole
Greene, Jacquelyn Nicole is an sole proprietor health care provider with primary practice located at 200 Fleetwood Dr , Easley SC 29640-2022. She recently has 3 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Internal Medicine, Allopathic & Osteopathic Physicians / Hospitalist, Physician Assistants & Advanced Practice Nursing Providers / Family. Physician Assistants & Advanced Practice Nursing Providers / Family is her primary health care specialty. Greene, Jacquelyn Nicole can be contacted via phone (864) 455-7000.Contact Information
Primary practice address
200 Fleetwood Dr
Easley SC 29640-2022
Phone: (864) 455-7000
Fax: (864) 442-8279
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Internal Medicine | 207R00000X | 23767 | South Carolina |
| Allopathic & Osteopathic Physicians / Hospitalist | 208M00000X | PENDING | South Carolina |
| Physician Assistants & Advanced Practice Nursing Providers / Family | 363LF0000X | 23767 | South Carolina |
Profile Details
| NPI number | 1063044600 |
|---|---|
| LBN Legal business name | Greene, Jacquelyn Nicole |
| Credentials | Family Nurse Practitioner (FNP) |
| Entity | Individual |
| Sole proprietor 1 | Yes |
| Enumeration date | Feb 11th, 2020 |
| Last updated | Jan 23rd, 2023 - about last year |
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 | 1063044600 | NPPES |
| South Carolina | MEDICAID | NP6819 |
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