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NPI Code Detail

MEDICARE: MS. JULIE K GREEN P.A.

MEDICARE: MS. JULIE K GREEN P.A.
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
1363A00000XPhysician Assistant3681CO

General Provider Information

NPI Number : 1497721666
Entity Type Code : Individual
Provider Name (Legal Business Name) : MS. JULIE K GREEN P.A.
Provider Business Mailing Address
First Line : PO BOX 360301
Second Line :
City : PITTSBURGH
State : PA
Zip : 15251-4124
Country : US
Telephone Number : 844-969-0686
Fax Number : 773-832-7083
Provider Business Practice Location Address
First Line : 1107 S LEMAY AVE STE 200
Second Line :
City : FORT COLLINS
State : CO
Zip : 80524-3959
Country : US
Telephone Number : 970-449-0315
Fax Number : 970-823-7007
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 02/27/2006
Last Update Date : 02/09/2024

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