Healthcare Provider Details

I. General information

NPI: 1154020022
Provider Name (Legal Business Name): MEGAN ELIZABETH GREEN APRN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 02/28/2023
Last Update Date: 05/08/2025
Certification Date: 08/30/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

YOUR HEALTH ORG. OF FLORIDA 1301 PLANTATION ISLAND DR. UNIT 303B
ST. AUGUSTINE FL
32080
US

IV. Provider business mailing address

SC HOUSE CALLS INC. 111 DOCTORS CIR.
COLUMBIA SC
29203
US

V. Phone/Fax

Practice location:
  • Phone: 800-491-0909
  • Fax: 855-866-8710
Mailing address:
  • Phone: 800-491-0909
  • Fax: 855-866-8710

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberAPRN11024967
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: