MS. KATHY E GREEN (NPI# 1306824784) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1306824784 |
| Entity Type | Individual |
| Full Name | MS. KATHY E GREEN |
| Credential | ARNP |
| Practice Address |
80 State St # 310 Canton NY 13617-1026 |
| Mailing Address |
80 State Highway 310 Ste 1 Canton NY 13617-1493 |
| Practice Telephone | 3153862167 |
| Mailing Telephone | 3153862167 |
| Mailing Fax Number | 2396241661 |
| Enumeration Date | 2006-01-05 |
| Last Update Date | 2018-04-20 |
| 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 |
F400400 | NY | Physician Assistants & Advanced Practice Nursing Providers |
| N | 363LP0808X |
Nurse Practitioner Specialization: Psych/Mental Health |
ARNP9385304 | FL | Physician Assistants & Advanced Practice Nursing Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| FL | BCBS | Y0NM1 | 01 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1073129078 | Kathy Lynn Green | In Home Supportive Care | 2261 Pinebrook Rd, Columbus, OH 43220-4327 | 2020-09-16 |
| 1487806733 | Kathy M Green | Licensed Practical Nurse | 35311 Greenwich Ave, North Ridgeville, OH 44039-1385 | 2008-10-17 |
| 1295287639 | Kathy Green | Nurse Practitioner | 5424 Discovery Park Boulevard, Bldg. B Suite 204, Williamsburg, VA 23188 | 2016-11-02 |
| 1588936488 | Kathy D. Green | Nurse Practitioner | 705 Riley Hospital Dr, Rr 208, Indianapolis, IN 46202-5109 | 2012-02-08 |
| 1053464065 | Kathy J. Green | Family Medicine | 4586 E Highway 20, Suite B, Niceville, FL 32578-9724 | 2007-01-21 |
| Street Address |
80 STATE ST # 310 |
| City | CANTON |
| State | NY |
| Zip Code | 13617-1026 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1700428802 | Meagan Elizabeth Hogan | Physician Assistant | 6119 Us Highway Route 11, Canton, NY 13617 | 2019-10-10 |
| 1982251740 | Wilma J. Blackmer | Technician | 1756 Cr 14, Canton, NY 13617 | 2019-08-26 |
| 1326525270 | Kylie Broughal | Physician Assistant | 6119 St Hwy Rt 11, St Lawrence Medical Office Complex, Canton, NY 13617 | 2018-07-24 |
| 1891299608 | Sheena Teresa Smith | Counselor | 310 State Highway 310, Suite 1, Canton, NY 13617 | 2018-03-19 |
| 1972024594 | Patrick James Sullivan | Physician Assistant | 6619 State Highway Route 11, Canton, NY 13617 | 2017-07-05 |
| 1225482763 | Howard Orthotics and Prosthetics, LLC | Prosthetic/Orthotic Supplier | 6128 Us Highway11, Canton, NY 13617 | 2016-04-21 |
| 1831534452 | Chin Hung Ho | Dermatology | 6119 State Highway Rt 11, Cph Dermotology, Canton, NY 13617 | 2013-05-09 |
| 1194061663 | Sarah Prairie | Counselor | 80 State Hwy 310, Suite 1, Canton, NY 13617 | 2013-01-02 |
| 1679859094 | Nathan Ellis | Occupational Therapist | 139 Outer State St. Rd, Canton, NY 13617 | 2011-10-31 |
| 1407139017 | Julianne Rutley | Occupational Therapist | 139 Outer State Street Rd, Canton, NY 13617 | 2011-09-21 |
| Find all providers in zip 13617 | ||||
| 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 |
|---|---|---|---|---|
| 1922666866 | Bright Minds Psychiatry,pllc | Nurse Practitioner | 575 Washington St Ste 1b, Canton, MA 02021-3011 | 2019-06-05 |
| 1366914970 | Nancy Louise Bennett | Nurse Practitioner | 328 E Otto St, Canton, MS 39046-4324 | 2018-12-20 |
| 1790227544 | Priscilla Anne Rice | Nurse Practitioner | 1271 Fulton Rd Nw, Canton, OH 44703-1463 | 2016-11-10 |
| 1053944298 | Megen Yerman | Nurse Practitioner | 624 Market Ave N, Canton, OH 44702-1017 | 2020-02-17 |
| 1285279901 | Grace Elizabeth Maxton | Nurse Practitioner | 4641 Fulton Dr Nw, Canton, OH 44718-2384 | 2019-11-18 |
| 1417502535 | Tiffany Nichol Brown | Nurse Practitioner | 1223 Market Ave N, Canton, OH 44714-2603 | 2019-08-06 |
| 1568022051 | Christopher Fogarty | Nurse Practitioner | 1320 Mercy Dr Nw, Canton, OH 44708-2614 | 2019-06-17 |
| 1184105223 | Elizabeth Pfalzgraf | Nurse Practitioner | 919 2nd St Ne, Canton, OH 44704-1132 | 2018-08-27 |
| 1629556949 | Judy Chava | Nurse Practitioner | 400 Tuscarawas St W, Canton, OH 44702 | 2018-07-30 |
| 1306331723 | Ashley Krusel | Nurse Practitioner | 4641 Fulton Dr Nw, Canton, OH 44718-2384 | 2018-06-27 |
| Find all providers in CANTON | ||||
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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.