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NPI Code Detail

MEDICARE: MRS. KELLERIE DAWN GREENE ARNP, FNP-C

MEDICARE: MRS. KELLERIE DAWN GREENE ARNP, 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 PractitionerARNP9282910FL

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 : 1205323706
Entity Type Code : Individual
Provider Name (Legal Business Name) : MRS. KELLERIE DAWN GREENE ARNP, FNP-C
Provider Business Mailing Address
First Line : 601 E ROLLINS ST
Second Line :
City : ORLANDO
State : FL
Zip : 32803-1248
Country : US
Telephone Number : 407-303-1812
Fax Number : 407-303-1815
Provider Business Practice Location Address
First Line : 601 E ROLLINS ST
Second Line :
City : ORLANDO
State : FL
Zip : 32803-1248
Country : US
Telephone Number : 407-303-1812
Fax Number : 407-303-1815
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 04/19/2018
Last Update Date : 01/16/2026

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