MEDICARE: EMILY ANN LEA 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
1	363LF0000X	Family Nurse Practitioner	827461	NV

General Provider Information

NPI Number	:	1235920570
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	EMILY ANN LEA GREEN NP

Provider Business Mailing Address
First Line	:	1035 PLENTYWOOD PL
Second Line	:
City	:	HENDERSON
State	:	NV
Zip	:	89002-9249
Country	:	US
Telephone Number	:	702-271-9818
Fax Number	:

Provider Business Practice Location Address
First Line	:	2960 SUNRIDGE HEIGHTS PKWY STE 100
Second Line	:
City	:	HENDERSON
State	:	NV
Zip	:	89052-4463
Country	:	US
Telephone Number	:	725-291-5900
Fax Number	:	725-291-5901

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

Provider Enumeration Date	:	05/15/2025
Last Update Date	:	05/15/2025

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