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General NPI Number Information
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NPI Number | 1093687444
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Entity Type | Organization
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Legal Business Name | EVERGREEN HEALTH INSTITUTE
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Dates
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Enumeration Date | 09/23/2025
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Last Update Date | 01/17/2026
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Provider Practice Location Address
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Address Line | 11528 LOUVRE PT
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City | PEYTON
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State | CO
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Zip | 80831-8225
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Country | US
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Telephone | 719-377-5152
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Fax |
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Provider Business Mailing Address
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Address Line | 11605 MERIDIAN MARKET VW STE 124
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City | FALCON
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State | CO
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Zip | 80831-8238
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Country | US
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Telephone | 719-377-5152
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Fax | 304-451-0033
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Authorized Official
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Title or Position | CEO
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Name | STEPHANIE GREEN
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Credential | NP
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Telephone | 304-860-2012
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number |
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License Number State |
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