MS. CHARLOTTE RENAE GREEN (NPI# 1174843742) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1174843742 |
| Entity Type | Individual |
| Full Name | MS. CHARLOTTE RENAE GREEN |
| Credential | PMHNP-BC |
| Practice Address |
4579 S Eason Blvd Tupelo MS 38801-6539 |
| Practice Telephone | 6623777590 |
| Practice Fax Number | 6623777595 |
| Mailing Telephone | 6623777590 |
| Mailing Fax Number | 6623777595 |
| Enumeration Date | 2010-06-07 |
| Last Update Date | 2010-06-07 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363LP0808X |
Nurse Practitioner Specialization: Psych/Mental Health |
R853585 | MS | Physician Assistants & Advanced Practice Nursing Providers |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1801268941 | Charlotte Green | Occupational Therapy Assistant | 3101 Ginger Dr, Tallahassee, FL 32308 | 2015-10-28 |
| Street Address |
4579 S EASON BLVD |
| City | TUPELO |
| State | MS |
| Zip Code | 38801-6539 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1508804626 | Mary Cecille Goysich | Psychologist | 4579 S Eason Blvd, Tupelo, MS 38801-6539 | 2006-06-02 |
| 1649890336 | Sandra Holmes | Counselor | 4579 S Eason Blvd, Tupelo, MS 38801-6539 | 2020-04-22 |
| 1235531658 | Phillipa Jones | Social Worker | 4579 S Eason Blvd, Tupelo, MS 38801-6539 | 2014-09-17 |
| 1982012506 | Malcolm Bell | Counselor | 4579 S Eason Blvd, Tupelo, MS 38801-6539 | 2014-07-28 |
| 1326454497 | Rhonda Smart | Marriage & Family Therapist | 4579 S Eason Blvd, Tupelo, MS 38801-6539 | 2014-07-09 |
| 1801202148 | Rodney Rogers | Marriage & Family Therapist | 4579 S Eason Blvd, Tupelo, MS 38801-6539 | 2014-07-08 |
| 1225444573 | Patricia Baggett | Counselor | 4579 S Eason Blvd, Tupelo, MS 38801-6539 | 2014-07-08 |
| 1790191112 | Susan Thomas Schuh | Counselor | 4579 S Eason Blvd, Tupelo, MS 38801-6539 | 2014-07-07 |
| 1376958199 | Gloria Temple Holland | Social Worker | 4579 S Eason Blvd, Tupelo, MS 38801-6539 | 2014-07-01 |
| 1164723318 | Aracelis Johanna Lu Brea | Psychiatry & Neurology | 4579 S Eason Blvd, Tupelo, MS 38801-6539 | 2010-11-04 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1194339275 | Friendship, LLC | Pharmacy | 4123 W Main St, Tupelo, MS 38801 | 2020-09-04 |
| 1003443458 | Nicole Sherice Taylor | Nurse Practitioner | 845 South Gloster Street, Tupelo, MS 38801 | 2020-03-25 |
| 1821556838 | Wilco Healthcare of North Mississippi, Pllc | Point of Service | 1514 Co Rd 41, Tupelo, MS 38801 | 2019-03-08 |
| 1821565235 | Stephanie K Cagle | Nurse Practitioner | 218 S Thomas St Ste 120-121, Tupelo, MS 38801 | 2018-10-24 |
| 1073092326 | Lauren Parrish | Nurse Practitioner | 1573 Medical Park Circle, Tupelo, MS 38801 | 2018-08-08 |
| 1467948687 | North Mississippi Medcial Center, Inc. | Nurse Practitioner | 990 S Madison St Ste 2, Tupelo, MS 38801 | 2018-07-11 |
| 1043700933 | Hooks Diabetes & Medicine Clinic | Non-Pharmacy Dispensing Site | 2610 Traceland Drive, Ste A, Tupelo, MS 38801 | 2018-05-16 |
| 1073035903 | Annette C Riddle | Counselor | 1004 Eisenhower Drive, Tupelo, MS 38801 | 2017-07-12 |
| 1548709678 | Jaime Summers | Nurse Practitioner | 2780 West Jackson St, Tupelo, MS 38801 | 2017-02-22 |
| 1073975611 | Heath Bryan Coleman, Dds of Mississippi II, Pllc | Dentist | 1168 Cross Creek Drive, Tupelo, MS 38801 | 2016-03-23 |
| Find all providers in zip 38801 | ||||
| Taxonomy Code | 363LP0808X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Nurse Practitioner |
| Specialization | Psych/Mental Health |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1548874159 | Susan Me'chelle Oliver | Nurse Practitioner | 874 Barnes Crossing Road, Tupelo, MS 38804 | 2020-09-01 |
| 1710532668 | Sondra Bennett Pmhnp-bc LLC | Nurse Practitioner | 144 S Thomas St Ste 207, Tupelo, MS 38801-5337 | 2019-08-07 |
| 1891353413 | Jennifer Warren Pmhnp-bc LLC | Nurse Practitioner | 315 Magazine St Ste D, Tupelo, MS 38804-3974 | 2019-05-29 |
| 1548783509 | Ashley Cooper | Nurse Practitioner | 499 Gloster Creek Vlg Ste A-3, Tupelo, MS 38801-4600 | 2017-07-21 |
| 1356707400 | Jennifer K Warren | Nurse Practitioner | 315 Magazine St Ste C, Tupelo, MS 38804-4802 | 2016-01-05 |
| 1750416905 | Lisa Theresa Lippincott | Nurse Practitioner | 210 E Main St Ste D, Tupelo, MS 38804-4017 | 2007-02-21 |
| 1275182818 | Andrea Paige Pounds | Nurse Practitioner | 2434 S Eason Blvd, Tupelo, MS 38804-6942 | 2019-09-06 |
| 1710532239 | Sabrina Hurd Hall | Nurse Practitioner | 1937 Briar Ridge Rd, Tupelo, MS 38804-5963 | 2019-08-02 |
| 1023572294 | Colby Ponder | Nurse Practitioner | 2434 S Eason Blvd, Tupelo, MS 38804-6942 | 2019-01-22 |
| 1730656422 | Emily L Mccormac | Nurse Practitioner | 2434 S Eason Blvd, Tupelo, MS 38804-6942 | 2018-10-31 |
| Find all providers in TUPELO | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.