MEDICARE: JULIA GREEN NP

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	363LA2200X	Adult Health Nurse Practitioner	APN.0994421-NP	CO

General Provider Information

NPI Number	:	1114391034
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JULIA GREEN NP

Provider Business Mailing Address
First Line	:	1936 IRVING ST APT B
Second Line	:
City	:	DENVER
State	:	CO
Zip	:	80204-5629
Country	:	US
Telephone Number	:	781-492-7107
Fax Number	:

Provider Business Practice Location Address
First Line	:	1936 IRVING ST APT B
Second Line	:
City	:	DENVER
State	:	CO
Zip	:	80204-5629
Country	:	US
Telephone Number	:	781-492-7107
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	11/16/2015
Last Update Date	:	09/28/2022

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