Healthcare Provider Details

I. General information

NPI: 1780726059
Provider Name (Legal Business Name): SHARI P GREEN RNCS, MA CAGS
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: SHARI PIZER

II. Dates (important events)

Enumeration Date: 02/13/2007
Last Update Date: 09/01/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

630 PLANTATION ST
WORCESTER MA
01605-2038
US

IV. Provider business mailing address

630 PLANTATION ST WOT 12TH FL
WORCESTER MA
01605-2038
US

V. Phone/Fax

Practice location:
  • Phone: 508-856-0732
  • Fax: 508-853-7149
Mailing address:
  • Phone: 508-368-5532
  • Fax: 508-853-7149

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code364S00000X
TaxonomyClinical Nurse Specialist
License NumberPPNS00104
License Number StateRI
# 2
Primary TaxonomyN
Taxonomy Code364SP0809X
TaxonomyAdult Psychiatric/Mental Health Clinical Nurse Specialist
License NumberRNCS229207
License Number StateMA
# 3
Primary TaxonomyN
Taxonomy Code364SP0809X
TaxonomyAdult Psychiatric/Mental Health Clinical Nurse Specialist
License NumberPPNS00104
License Number StateRI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: