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NPI Code Detail

MEDICARE: LAUREN B GREEN FNP-C

MEDICARE: LAUREN B GREEN FNP-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
1363LF0000XFamily Nurse Practitioner1-153338AL

General Provider Information

NPI Number : 1144812371
Entity Type Code : Individual
Provider Name (Legal Business Name) : LAUREN B GREEN FNP-C
Provider Business Mailing Address
First Line : 6228 BRADLEY PARK DR STE A
Second Line :
City : COLUMBUS
State : GA
Zip : 31904-3605
Country : US
Telephone Number : 706-322-1486
Fax Number : 706-324-3419
Provider Business Practice Location Address
First Line : 6228 BRADLEY PARK DR STE A
Second Line :
City : COLUMBUS
State : GA
Zip : 31904-3605
Country : US
Telephone Number : 706-322-1486
Fax Number : 706-324-3419
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 02/09/2021
Last Update Date : 02/09/2021

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Directions to “ LAUREN B GREEN FNP-C” Practice Location

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