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General NPI Number Information
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NPI Number | 1154195469
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Entity Type | Individual
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Provider Name | JESSICA ERIN GREEN RDN
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Gender | Female
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Dates
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Enumeration Date | 11/08/2023
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Last Update Date | 02/26/2025
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Provider Practice Location Address
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Address Line | 11700 W. 2ND PLACE MEDICAL PLAZA 2, STE 310
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City | LAKEWOOD
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State | CO
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Zip | 80228
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Country | US
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Telephone | 720-321-8300
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Fax | 720-321-8301
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Provider Business Mailing Address
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Address Line | 11700 W. 2ND PLACE MEDICAL PLAZA 2, STE 310
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City | LAKEWOOD
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State | CO
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Zip | 80228
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Country | US
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Telephone | 720-321-8300
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Fax | 720-321-8301
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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 | 133V00000X
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Taxonomy Name | Registered Dietitian
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License Number | LD-1352
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License Number State | NM
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Taxonomy #2
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Taxonomy Code | 133V00000X
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Taxonomy Name | Registered Dietitian
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License Number | 10202320
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License Number State | OR
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Taxonomy #3
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Taxonomy Code | 133V00000X
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Taxonomy Name | Registered Dietitian
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License Number | 61000856
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License Number State | WA
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Taxonomy #4
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Taxonomy Code | 133V00000X
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Taxonomy Name | Registered Dietitian
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License Number | 1154
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License Number State | ID
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Taxonomy #5
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Taxonomy Code | 133V00000X
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Taxonomy Name | Registered Dietitian
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License Number |
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License Number State |
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Taxonomy #6
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Taxonomy Code | 133V00000X
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Taxonomy Name | Registered Dietitian
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License Number | DT81445
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License Number State | TX
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