Healthcare Provider Details

I. General information

NPI: 1013458629
Provider Name (Legal Business Name): JENNIFER LINDSEY ATWOOD GREEN RN, PMHNP-BC
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/15/2017
Last Update Date: 04/16/2026
Certification Date: 04/16/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

11022 S 51ST ST STE 250
PHOENIX AZ
85044-4319
US

IV. Provider business mailing address

44480 W HONEYCUTT RD STE 103
MARICOPA AZ
85138-2909
US

V. Phone/Fax

Practice location:
  • Phone: 480-939-6137
  • Fax: 602-429-8445
Mailing address:
  • Phone: 520-980-9251
  • Fax: 520-667-2397

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License NumberAP9968
License Number StateAZ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: