Basic Information
| Provider Information | |||||||||
| NPI: | 1780087304 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | GREER | ||||||||
| FirstName: | ANITA | ||||||||
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| Mailing Information | |||||||||
| Address1: | 220 HIGHWAY 12 W | ||||||||
| Address2: | BAPTIST MED CTR KOSCIUSKO | ||||||||
| City: | KOSCIUSKO | ||||||||
| State: | MS | ||||||||
| PostalCode: | 390903208 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6622903150 | ||||||||
| FaxNumber: | 6622903160 | ||||||||
| Practice Location | |||||||||
| Address1: | 3812 ATTALA ROAD 1137 | ||||||||
| Address2: | |||||||||
| City: | KOSCIUSKO | ||||||||
| State: | MS | ||||||||
| PostalCode: | 390904556 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6622891607 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 09/28/2014 | ||||||||
| LastUpdateDate: | 04/21/2016 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 363L00000X | R858205 | MS | Y | Physician Assistants & Advanced Practice Nursing Providers | Nurse Practitioner |
No ID Information.