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General NPI Number Information
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NPI Number | 1881679595
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Entity Type | Individual
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Provider Name | STEPHEN MARK GREEN CRNA
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Gender | Male
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Dates
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Enumeration Date | 12/14/2005
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Last Update Date | 05/26/2023
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Provider Practice Location Address
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Address Line | 1901 MEDI PARK DR STE 2
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City | AMARILLO
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State | TX
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Zip | 79106-2105
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Country | US
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Telephone | 806-350-7918
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Fax |
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Provider Business Mailing Address
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Address Line | 101 W LOUIS HENNA BLVD STE 300
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City | AUSTIN
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State | TX
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Zip | 78728-1203
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Country | US
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Telephone | 512-244-4272
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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 | 367500000X
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Taxonomy Name | Certified Registered Nurse Anesthetist
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License Number | RNA123016
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License Number State | ME
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Taxonomy #2
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Taxonomy Code | 367500000X
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Taxonomy Name | Certified Registered Nurse Anesthetist
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License Number | 059893-23
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License Number State | NH
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Taxonomy #3
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Taxonomy Code | 367500000X
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Taxonomy Name | Certified Registered Nurse Anesthetist
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License Number | 101-0032498
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License Number State | VT
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Taxonomy #4
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Taxonomy Code | 367500000X
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Taxonomy Name | Certified Registered Nurse Anesthetist
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License Number | 201260025CRNA
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License Number State | OR
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Taxonomy #5
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Taxonomy Code | 367500000X
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Taxonomy Name | Certified Registered Nurse Anesthetist
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License Number | 1082
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License Number State | TX
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Taxonomy #6
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Taxonomy Code | 367500000X
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Taxonomy Name | Certified Registered Nurse Anesthetist
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License Number | RN271326
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License Number State | MA
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Taxonomy #7
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Taxonomy Code | 367500000X
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Taxonomy Name | Certified Registered Nurse Anesthetist
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License Number | AP30004631
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License Number State | WA
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Taxonomy #8
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Taxonomy Code | 367500000X
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Taxonomy Name | Certified Registered Nurse Anesthetist
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License Number | 73353
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License Number State | NM
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Taxonomy #9
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Taxonomy Code | 367500000X
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Taxonomy Name | Certified Registered Nurse Anesthetist
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License Number | AP109124
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License Number State | TX
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