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NPI Code Detail

MEDICARE: DENA NIGEL GREEN

MEDICARE: DENA NIGEL GREEN
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
1171M00000XCase Manager/Care Coordinator

General Provider Information

NPI Number : 1649413113
Entity Type Code : Individual
Provider Name (Legal Business Name) : DENA NIGEL GREEN
Provider Business Mailing Address
First Line : 4701 HAVERWOOD LN
Second Line : APT 1224
City : DALLAS
State : TX
Zip : 75287-4227
Country : US
Telephone Number : 214-708-5173
Fax Number : 972-448-8532
Provider Business Practice Location Address
First Line : 4701 HAVERWOOD LN
Second Line : APT 1224
City : DALLAS
State : TX
Zip : 75287-4227
Country : US
Telephone Number : 214-708-5173
Fax Number : 972-448-8532
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 04/14/2009
Last Update Date : 04/14/2009

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Directions to “ DENA NIGEL GREEN ” Practice Location

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