Provider Demographics
NPI:1255030516
Name:GREENLEE, ERIN PAIGE (PMHNP)
Entity type:Individual
Prefix:
First Name:ERIN
Middle Name:PAIGE
Last Name:GREENLEE
Suffix:
Gender:F
Credentials:PMHNP
Other - Prefix:
Other - First Name:ERIN
Other - Middle Name:PAIGE
Other - Last Name:ROSS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:RN
Mailing Address - Street 1:5300 STEWART RD
Mailing Address - Street 2:
Mailing Address - City:LEXINGTON
Mailing Address - State:KY
Mailing Address - Zip Code:40516-9519
Mailing Address - Country:US
Mailing Address - Phone:740-505-4242
Mailing Address - Fax:
Practice Address - Street 1:503 DARBY CREEK RD UNIT C
Practice Address - Street 2:
Practice Address - City:LEXINGTON
Practice Address - State:KY
Practice Address - Zip Code:40509-1603
Practice Address - Country:US
Practice Address - Phone:859-368-2567
Practice Address - Fax:859-788-3905
Is Sole Proprietor?:No
Enumeration Date:2023-02-27
Last Update Date:2024-06-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY1140495163W00000X
KY4010911363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health
No163W00000XNursing Service ProvidersRegistered Nurse