Crystal Latasha Greene

Primary specialty

Nurse's AideTaxonomy code 376K00000X

License

CN0014183784 Issued in GA

Practice address

5030 W Mountain St Apt 18
Stone Mountain, GA 30083-2845

Phone

(678) 334-4914

NPI assigned

Oct 18, 2021

Last updated

Oct 18, 2021By the provider in NPPES

Sex

Female

Sole proprietor

Yes

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1634515200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1634515200000",
    "number": "1417610387",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5030 W MOUNTAIN ST APT 18",
            "city": "STONE MOUNTAIN",
            "state": "GA",
            "postal_code": "300832845",
            "telephone_number": "678-334-4914"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5030 W MOUNTAIN ST APT 18",
            "city": "STONE MOUNTAIN",
            "state": "GA",
            "postal_code": "300832845",
            "telephone_number": "678-334-4914"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GREENE",
        "first_name": "CRYSTAL",
        "middle_name": "LATASHA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2021-10-18",
        "last_updated": "2021-10-18",
        "certification_date": "2021-10-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "376K00000X",
            "taxonomy_group": "",
            "desc": "Nurse's Aide",
            "state": "GA",
            "license": "CN0014183784",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Natolie Nicole Gray, LPC
• Phyllis Myra Grayson, R.PH.
• Greater Atlanta Pediatrics PC
• Green Mind Behavioral Health Services LLC
• Benita Green
• Greenlee Behavioral Health Services, LLC.
• Greenridge Community Integration Home
• Natasha C Gresham, LPC
• Lashawnda M Grier
• Torri L Griffin, PH.D.

• Nurse's Aide in Stone Mountain, GA
• Providers in Stone Mountain, GA by specialty
• Nurse's Aide in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 18, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.