Healthcare Provider Details

I. General information

NPI: 1780564229
Provider Name (Legal Business Name): MRS. LAUREN NICOLE GREEN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/04/2025
Last Update Date: 05/15/2026
Certification Date: 05/15/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2010 BROOKWOOD MEDICAL CTR DR
BIRMINGHAM AL
35209-6804
US

IV. Provider business mailing address

4944 HAWTHORNE PL
CHELSEA AL
35043-7269
US

V. Phone/Fax

Practice location:
  • Phone: 833-251-9895
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code367500000X
TaxonomyCertified Registered Nurse Anesthetist
License Number177495
License Number StateAL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: