JENNIFER NICOLE GREEN NP-C NPI 1073064242

NPI Information

NPI: 1073064242
Provider Name: JENNIFER NICOLE GREEN, NP-C
Classification: Nurse Practitioner - 363LF0000X
Entity Type: Individual

Specialization: Family

PECOS Registration: Yes

Address:
500 W 190TH ST STE 400
GARDENA, CA
ZIP 90248
Phone: (931) 384-8212
Get Directions

Jennifer Nicole Green, NP-C is a family nurse practitioner in Gardena, CA. Jennifer Nicole Green, NP-C NPI is 1073064242. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a female.

The provider's business location address is:

500 W 190TH ST STE 400
GARDENA, CA
ZIP 90248-290
Phone: (931) 384-8212

The NPI 1073064242 is registered in the Medicare Provider, Enrollment, Chain and Ownership System (PECOS). The provider is legally eligible to order and refer Part B (Clinical Laboratory and Imaging), Durable Medical Equipment, Part A Home Health Agency (HHA), Power Mobility Devices.

The enumeration date for this NPI number is 10/21/2016 and was last updated on 10/30/2021.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	363LF0000X	Nurse Practitioner	Family	22027	TENNESSEE	No
2	363LF0000X	Nurse Practitioner	Family	903916	MISSISSIPPI	Yes

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 11/14/2023

NPI Synchronization or Removal

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