Provider Demographics
NPI:1053005629
Name:GREENE, TONI LYNN
Entity type:Individual
Prefix:
First Name:TONI
Middle Name:LYNN
Last Name:GREENE
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:263 S 3200 W
Mailing Address - Street 2:
Mailing Address - City:WESTON
Mailing Address - State:ID
Mailing Address - Zip Code:83286-5046
Mailing Address - Country:US
Mailing Address - Phone:208-940-1603
Mailing Address - Fax:
Practice Address - Street 1:263 S 3200 W
Practice Address - Street 2:
Practice Address - City:WESTON
Practice Address - State:ID
Practice Address - Zip Code:83286-5046
Practice Address - Country:US
Practice Address - Phone:208-940-1603
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-06-06
Last Update Date:2023-06-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes376J00000XNursing Service Related ProvidersHomemaker