Basic Information
| Provider Information | |||||||||
| NPI: | 1033420815 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | GREER | ||||||||
| FirstName: | CASSIE | ||||||||
| MiddleName: | STAR | ||||||||
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| Credential: | ARNP | ||||||||
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| Mailing Information | |||||||||
| Address1: | 1909 BEACH BLVD STE 102 | ||||||||
| Address2: | |||||||||
| City: | JACKSONVILLE BEACH | ||||||||
| State: | FL | ||||||||
| PostalCode: | 322502643 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9042462752 | ||||||||
| FaxNumber: | 9042462758 | ||||||||
| Practice Location | |||||||||
| Address1: | 1909 BEACH BLVD STE 102 | ||||||||
| Address2: | |||||||||
| City: | JACKSONVILLE BEACH | ||||||||
| State: | FL | ||||||||
| PostalCode: | 32250 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9042462752 | ||||||||
| FaxNumber: | 9042462758 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 06/28/2010 | ||||||||
| LastUpdateDate: | 10/21/2019 | ||||||||
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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 | 9217073 | FL | N | Physician Assistants & Advanced Practice Nursing Providers | Nurse Practitioner | 363LX0001X | ELIGIBLE | FL | N | Physician Assistants & Advanced Practice Nursing Providers | Nurse Practitioner | Obstetrics & Gynecology | 363LW0102X | APRN9217073 | FL | Y | Physician Assistants & Advanced Practice Nursing Providers | Nurse Practitioner | Women's Health |
ID Information
| ID | Type | State | Issuer | Description | P934710 | 01 | FL | OPTIMUM | OTHER | 710410 | 01 | FL | WELLCARE | OTHER | 003466100 | 05 | FL | MEDICAID | P00929821 | 01 | FL | RAILROAD MCR | OTHER | 47932 | 01 | FL | UNIVERSAL HEALTHCARE | OTHER | P990169 | 01 | FL | FREEDOM HEALTH | OTHER | Y06YR | 01 | FL | BCBS FL | OTHER |