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NPI Code Detail

MEDICARE: DONNA J GREEN NP

MEDICARE: DONNA J GREEN NP
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
1363LF0000XFamily Nurse Practitioner582607TX

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1124123237
Entity Type Code : Individual
Provider Name (Legal Business Name) : DONNA J GREEN NP
Provider Business Mailing Address
First Line : 9991 MARSH LN
Second Line :
City : DALLAS
State : TX
Zip : 75220-1766
Country : US
Telephone Number : 214-358-0090
Fax Number : 214-358-0760
Provider Business Practice Location Address
First Line : 9991 MARSH LN
Second Line :
City : DALLAS
State : TX
Zip : 75220-1766
Country : US
Telephone Number : 214-358-0090
Fax Number : 214-358-0760
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 09/13/2006
Last Update Date : 03/29/2012

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