Provider Demographics
NPI:1871628180
Name:GREER, GREGORY PAUL (CRNA, MHS)
Entity type:Individual
Prefix:MR
First Name:GREGORY
Middle Name:PAUL
Last Name:GREER
Suffix:
Gender:M
Credentials:CRNA, MHS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3900 ACADIAN VILLAGE DR
Mailing Address - Street 2:
Mailing Address - City:OCEAN SPRINGS
Mailing Address - State:MS
Mailing Address - Zip Code:39564-6205
Mailing Address - Country:US
Mailing Address - Phone:228-219-3064
Mailing Address - Fax:
Practice Address - Street 1:2101 HIGHWAY 90
Practice Address - Street 2:
Practice Address - City:GAUTIER
Practice Address - State:MS
Practice Address - Zip Code:39553-5340
Practice Address - Country:US
Practice Address - Phone:228-809-5000
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-02-23
Last Update Date:2017-01-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MSR864500367500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367500000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Anesthetist, Certified Registered
Provider Identifiers
StateIdentifier IDID TypeIssuer
P00068088OtherRAILROAD MEDICARE
640942692OtherBLUE CROSS OF MS
MSGG00124973Medicaid
438566298OtherTRICARE