INA GREEN (NPI# 1467699025) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1467699025 |
| Entity Type | Individual |
| Full Name | INA GREEN |
| Credential | PAC |
| Practice Address |
4335 Se 15th St Del City OK 73115-3001 |
| Mailing Address |
Po Box 14587 Oklahoma City OK 73113-0587 |
| Practice Telephone | 4056009988 |
| Practice Fax Number | 4056009989 |
| Mailing Telephone | 4056009988 |
| Mailing Fax Number | 4056009989 |
| Enumeration Date | 2009-01-19 |
| Last Update Date | 2009-01-19 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363A00000X | Physician Assistant | 1010 | OK | Physician Assistants & Advanced Practice Nursing Providers |
| Street Address |
4335 SE 15TH ST |
| City | DEL CITY |
| State | OK |
| Zip Code | 73115-3001 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1386881944 | Fastcare Medical Clinic of Del City | Family Medicine | 4335 Se 15th St, Del City, OK 73115-3001 | 2009-01-19 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1639776222 | Physicians Choice Dialysis of Midwest City LLC | Technician, Other | 3200 Se 29th Street, Del City, OK 73115 | 2020-10-06 |
| 1942784715 | Iacc/ehi Nw, LLC | General Acute Care Hospital | 4801 S.e. 15th Street, Del City, OK 73115 | 2018-09-18 |
| 1285164392 | Jerry Medlock | Peer Specialist | 4312 Vfw Dr. Apt # 7, 4312 Vfw Dr. Apt # 7, Del City, OK 73115 | 2017-06-13 |
| 1326425588 | Peace of Mind Pediatrics Pllc | Clinic/Center | 5476 Main Street, 104, Del City, OK 73115 | 2015-04-27 |
| 1588077044 | Latasha Aujena Walker | Case Management | 4337 Se15th, Del City, OK 73115 | 2014-06-03 |
| 1164834701 | Affordable Dentures-midwest City, P.C. | Dentist | 5301 Main Street, Suite 111, Del City, OK 73115 | 2014-06-02 |
| 1629488028 | Nikke Sogunro | Counselor | 3517 Ridglea Ct., Del City, OK 73115 | 2014-05-07 |
| 1033539358 | Shelli Holtsman | Counselor | 4329 Se 40th Street, Del City, OK 73115 | 2014-04-25 |
| 1215238514 | Tonya Dailwayne Wilson | Counselor | 4016 S.e. 24th Street, Del City, OK 73115 | 2010-11-03 |
| 1851611099 | Kelly Camille Kingsley | Behavioral Analyst | 4018 Se 11th Street, Del City, OK 73115 | 2010-06-10 |
| Find all providers in zip 73115 | ||||
| Taxonomy Code | 363A00000X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Physician Assistant |
| A physician assistant is a person who has successfully completed an accredited education program for physician assistant, is licensed by the state and is practicing within the scope of that license. Physician assistants are formally trained to perform many of the routine, time-consuming tasks a physician can do. In some states, they may prescribe medications. They take medical histories, perform physical exams, order lab tests and x-rays, and give inoculations. Most states require that they work under the supervision of a physician. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1972035145 | Jacob C. Brown | Physician Assistant | 5300 Se 29th St, Del City, OK 73115-4702 | 2017-03-28 |
| 1922570068 | Ashlynn Garzon | Physician Assistant | 5300 Se 29th St, Del City, OK 73115-4702 | 2018-12-31 |
| 1336630326 | Ashton Robertson | Physician Assistant | 5300 Se 29th St, Del City, OK 73115-4702 | 2018-05-24 |
| 1396785390 | Brandon Scott Funk | Physician Assistant | 4600 Se 29th St, Suite 750, Del City, OK 73115-3406 | 2006-06-07 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1194326496 | Courtland Henderson | Physician Assistant | 2614 Wagon Trl, Enid, OK 73703-1630 | 2020-11-03 |
| 1013517168 | Madeleine Hill | Physician Assistant | 5304 N Hudson Ave, Oklahoma City, OK 73118-6232 | 2020-10-28 |
| 1851990097 | Lauren Heim | Physician Assistant | 7324 Bucks Xing, Edmond, OK 73034-3520 | 2020-10-19 |
| 1003414673 | Stephanie Ann Stephens | Physician Assistant | 5021 Eric Dr, Oklahoma City, OK 73135-4129 | 2020-10-15 |
| 1508464355 | Lauren Danielle Ukleya | Physician Assistant | 1315 Chisholm Trail Pkwy Ste A, Duncan, OK 73533-1544 | 2020-10-14 |
| 1598362964 | Madison Kitchens | Physician Assistant | 471688 Ok-51, Stilwell, OK 74960 | 2020-10-07 |
| 1689271041 | Maissa Baker Mitwalli | Physician Assistant | 700 S Desert Palm Ave, Broken Arrow, OK 74012-8815 | 2020-10-07 |
| 1730705229 | Jenna Specht | Physician Assistant | 2501 N 14th St, Ponca City, OK 74601-1734 | 2020-06-19 |
| 1477176147 | April Dawn Sullivan | Physician Assistant | 1111 Walnut Dr, Ardmore, OK 73401-2354 | 2020-05-28 |
| 1497384754 | Leah Cannady Hester | Physician Assistant | 3145 Midland Valley St, Norman, OK 73069-6970 | 2020-04-07 |
| Find all providers with the same taxonomy | ||||
Please comment or provide details below to improve the information on INA GREEN.
| 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.