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General NPI Number Information
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NPI Number | 1083166029
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Entity Type | Individual
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Provider Name | ALISON J GREEN MSN, FNP-C
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Gender | Female
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Dates
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Enumeration Date | 10/25/2016
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Last Update Date | 02/07/2020
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Provider Practice Location Address
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Address Line | 2400 LANCASTER DR NE
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City | SALEM
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State | OR
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Zip | 97305-1221
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Country | US
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Telephone | 503-361-5400
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Fax |
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Provider Business Mailing Address
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Address Line | 1451 24TH ST APT. 326
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City | DENVER
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State | CO
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Zip | 80205-2104
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Country | US
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Telephone | 308-760-4055
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Fax |
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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 | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | 201907149NP-PP
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License Number State | OR
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