Healthcare Provider Details

I. General information

NPI: 1679490056
Provider Name (Legal Business Name): NAJEE GREEN ES017547
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/06/2026
Last Update Date: 07/06/2026
Certification Date: 07/06/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3480 GREENBRIAR PKWY SW STE 225B
ATLANTA GA
30331-3132
US

IV. Provider business mailing address

3573 BLUEBIRD CT SW
ATLANTA GA
30331-3137
US

V. Phone/Fax

Practice location:
  • Phone: 470-548-8588
  • Fax:
Mailing address:
  • Phone: 470-548-8588
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code174400000X
TaxonomySpecialist
License NumberES017547
License Number StateGA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: