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General NPI Number Information
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NPI Number | 1083114730
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Entity Type | Individual
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Provider Name | GINA ANN GREEN FNP
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Gender | Female
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Dates
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Enumeration Date | 02/20/2018
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Last Update Date | 10/21/2025
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Provider Practice Location Address
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Address Line | 401 W MAIN ST STE 1810
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City | LOUISVILLE
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State | KY
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Zip | 40202-2927
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Country | US
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Telephone | 888-349-1116
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Fax |
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Provider Business Mailing Address
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Address Line | 12201 BLUEGRASS PKWY
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City | LOUISVILLE
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State | KY
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Zip | 40299-2361
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Country | US
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Telephone | 502-568-7364
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Fax | 502-568-7136
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363L00000X
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Taxonomy Name | Nurse Practitioner
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License Number | GAA-NP002452
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License Number State | GA
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Taxonomy #2
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Taxonomy Code | 363L00000X
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Taxonomy Name | Nurse Practitioner
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License Number | 3-001853
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License Number State | AL
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Taxonomy #3
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Taxonomy Code | 363L00000X
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Taxonomy Name | Nurse Practitioner
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License Number | 237336
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License Number State | LA
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Taxonomy #4
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Taxonomy Code | 363L00000X
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Taxonomy Name | Nurse Practitioner
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License Number | 71014463A
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License Number State | IN
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Taxonomy #5
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Taxonomy Code | 363L00000X
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Taxonomy Name | Nurse Practitioner
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License Number | 0032484
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License Number State | OH
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Taxonomy #6
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Taxonomy Code | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | 3011037
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License Number State | KY
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Taxonomy #7
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Taxonomy Code | 363L00000X
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Taxonomy Name | Nurse Practitioner
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License Number | 3011037
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License Number State | KY
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