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General NPI Number Information
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NPI Number | 1710600135
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Entity Type | Individual
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Provider Name | KATRINA MASON - GREEN
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Gender | Female
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Dates
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Enumeration Date | 09/21/2022
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Last Update Date | 07/09/2025
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Provider Practice Location Address
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Address Line | 715 S POWELL PKWY
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City | ANNA
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State | TX
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Zip | 75409-2586
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Country | US
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Telephone | 732-318-7465
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Fax | 682-213-2892
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Provider Business Mailing Address
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Address Line | 2021 WIMBLEDON DR
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City | ALLEN
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State | TX
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Zip | 75013-3027
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Country | US
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Telephone | 732-318-7465
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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 | 363L00000X
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Taxonomy Name | Nurse Practitioner
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License Number | 1090458
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License Number State | TX
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Taxonomy #2
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Taxonomy Code | 163WG0000X
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Taxonomy Name | General Practice Registered Nurse
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License Number | 1090458
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License Number State | TX
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