Provider Demographics
NPI:1447664115
Name:GREER, DEBRA KAY (LPN)
Entity type:Individual
Prefix:
First Name:DEBRA
Middle Name:KAY
Last Name:GREER
Suffix:
Gender:F
Credentials:LPN
Other - Prefix:
Other - First Name:DEBRA
Other - Middle Name:KAY
Other - Last Name:HURT
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:LPN
Mailing Address - Street 1:1167 SPRATLIN PARK DR
Mailing Address - Street 2:POB 9054
Mailing Address - City:GRAY
Mailing Address - State:TN
Mailing Address - Zip Code:37615-6205
Mailing Address - Country:US
Mailing Address - Phone:423-467-3600
Mailing Address - Fax:423-467-3644
Practice Address - Street 1:218 N MAIN AVE
Practice Address - Street 2:
Practice Address - City:ERWIN
Practice Address - State:TN
Practice Address - Zip Code:37650-1234
Practice Address - Country:US
Practice Address - Phone:423-743-1470
Practice Address - Fax:423-467-3644
Is Sole Proprietor?:No
Enumeration Date:2014-06-20
Last Update Date:2014-06-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN61811164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse