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1538141221

NPI Code Detail

MEDICARE: MS. LYNDA ANN GREEN CNP GNP

MEDICARE: MS. LYNDA ANN GREEN CNP GNP

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	363LC1500X	Community Health Nurse Practitioner	53135-1214	LA
2	363LF0000X	Family Nurse Practitioner	A002938	AR
3	363LF0000X	Family Nurse Practitioner	APO1214	LA
4	363LF0000X	Family Nurse Practitioner	CNP02366	NM
5	363LG0600X	Gerontology Nurse Practitioner	APO1214	LA
6	363LP2300X	Primary Care Nurse Practitioner	APO1214	LA
7	363LF0000X	Family Nurse Practitioner	35835	TN
8	363L00000X	Nurse Practitioner	AP145992	TX

General Provider Information

NPI Number	:	1538141221
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MS. LYNDA ANN GREEN CNP GNP

Provider Business Mailing Address
First Line	:	PO BOX 2861
Second Line	:
City	:	CROSSVILLE
State	:	TN
Zip	:	38557-2861
Country	:	US
Telephone Number	:	931-879-5864
Fax Number	:

Provider Business Practice Location Address
First Line	:	100 S DUNCAN ST
Second Line	:
City	:	JAMESTOWN
State	:	TN
Zip	:	38556-3009
Country	:	US
Telephone Number	:	931-879-5864
Fax Number	:

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

Provider Enumeration Date	:	11/17/2005
Last Update Date	:	04/17/2024

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Directions to “ MS. LYNDA ANN GREEN CNP GNP” Practice Location

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