Healthcare Provider Details

I. General information

NPI: 1225860711
Provider Name (Legal Business Name): GREEN LOTUS HEALTH & WELLNESS, PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/14/2024
Last Update Date: 12/20/2025
Certification Date: 12/20/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2101 S BLACKHAWK ST STE 240
AURORA CO
80014-1475
US

IV. Provider business mailing address

212 NW 5TH STREET
GUYMON OK
73942-4204
US

V. Phone/Fax

Practice location:
  • Phone: 501-613-7863
  • Fax: 580-297-9105
Mailing address:
  • Phone: 580-338-7462
  • Fax: 855-538-3350

VI. Provider taxonomy

Scope of Practice (Provider specialty)

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

VIII. Authorized Official

Name: MARLENE ANGELA BROWN
Title or Position: OWNER
Credential: APRN-CNP, PMHNP-BC
Phone: 580-338-7462