MEDICARE: MRS. MICHELLE GREEN PA-C

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	363A00000X	Physician Assistant

General Provider Information

NPI Number	:	1043754641
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MRS. MICHELLE GREEN PA-C

Provider Business Mailing Address
First Line	:	9228 S MINGO RD STE 102
Second Line	:
City	:	TULSA
State	:	OK
Zip	:	74133-5721
Country	:	US
Telephone Number	:	918-592-0999
Fax Number	:

Provider Business Practice Location Address
First Line	:	9228 S MINGO RD STE 102
Second Line	:
City	:	TULSA
State	:	OK
Zip	:	74133-5721
Country	:	US
Telephone Number	:	918-592-0999
Fax Number	:	918-595-0208

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	12/15/2016
Last Update Date	:	07/18/2022

Similar Medicare Providers

1902027758 — MRS. TONYA ALLEN MS, LPC
Practice Location Address:

9228 S MINGO RD STE 101
TULSA, OK
74133-5721

Practice Phone: 405-378-2727
Practice Fax:

1770115420 — MRS. ALEXANDRIA MICHELLE INGRAM FNP-C
Practice Location Address:

9228 S MINGO RD STE 102
TULSA, OK
74133-5721

Practice Phone: 918-592-0999
Practice Fax:

1417918954 — DR. DANA DENISE MORREL M.D.
Practice Location Address:

9228 S. MINGO , SUITE 103
TULSA, OK
74133-5721

Practice Phone: 918-392-7575
Practice Fax: 918-615-3465

1366493975 — MRS. STEPHANIE LYNN CAUGHMAN CPNP
Practice Location Address:

9228 S MINGO RD
TULSA, OK
74133-5721

Practice Phone: 918-254-6822
Practice Fax: 918-254-6823

1962432757 — DR. PATTI WANNETTA SHAW D.O.
Practice Location Address:

9228 S. MINGO , SUITE 103
TULSA, OK
74133-5721

Practice Phone: 918-392-7575
Practice Fax: 918-615-3465

1164640496 — DARREN EDDY MDIV, MA, LPC
Practice Location Address:

9228 S MINGO RD STE 101
TULSA, OK
74133-5721

Practice Phone: 405-378-2727
Practice Fax:

Directions to “ MRS. MICHELLE GREEN PA-C” Practice Location

Language	Start Address	Practice Location

These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

Copyright © 2007-2026 (Powered by Swiss Vault Engine), all rights reserved. HIPAA liability, trademark, document use and software licensing rules apply. All registered trademarks, used in the content, are the property of their owners. Your interactions with this site are in accordance with our Terms of Use and Privacy Policy.