=====================================================
General NPI Number Information
=====================================================
NPI Number | 1326759663
-----------------------------------------------------
Entity Type | Individual
-----------------------------------------------------
Provider Name | HOLLIE BOYER GREEN AU.D.
-----------------------------------------------------
Gender | Female
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 12/07/2022
-----------------------------------------------------
Last Update Date | 01/14/2025
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 433 N PINE STREET
-----------------------------------------------------
City | FLORENCE
-----------------------------------------------------
State | AL
-----------------------------------------------------
Zip | 35630
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 256-740-8383
-----------------------------------------------------
Fax | 256-461-1228
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 8075 MADISON BLVD SUITE 108
-----------------------------------------------------
City | MADISON
-----------------------------------------------------
State | AL
-----------------------------------------------------
Zip | 35758
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 256-319-4327
-----------------------------------------------------
Fax | 256-461-1228
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position |
-----------------------------------------------------
Name |
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone |
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 231H00000X
-----------------------------------------------------
Taxonomy Name | Audiologist
-----------------------------------------------------
License Number | 13612
-----------------------------------------------------
License Number State | AL
-----------------------------------------------------
Taxonomy #2
-----------------------------------------------------
Taxonomy Code | 231H00000X
-----------------------------------------------------
Taxonomy Name | Audiologist
-----------------------------------------------------
License Number | 5272
-----------------------------------------------------
License Number State | AL
-----------------------------------------------------