MS. FAQUETA KENISHA GREEN (NPI# 1558992974) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1558992974 |
| Entity Type | Individual |
| Full Name | MS. FAQUETA KENISHA GREEN |
| Credential | APRN, PMHNP-BC |
| Practice Address |
633 Stephenson Ave Savannah GA 31405-5970 |
| Mailing Address |
134 Roseberry Cir Port Wentworth GA 31407-5613 |
| Practice Telephone | 9122243641 |
| Mailing Telephone | 9122243641 |
| Enumeration Date | 2020-02-04 |
| Last Update Date | 2020-02-04 |
| Gender Code | F |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363LP0808X |
Nurse Practitioner Specialization: Psych/Mental Health |
209710 | GA | Physician Assistants & Advanced Practice Nursing Providers |
| Street Address |
633 STEPHENSON AVE |
| City | SAVANNAH |
| State | GA |
| Zip Code | 31405-5970 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1427292333 | Uhs of Savannah LLC | Psychiatric Hospital | 633 Stephenson Ave, Savannah, GA 31405-5970 | 2009-04-22 |
| 1336775550 | Tshaun Grant | Nurse Practitioner | 633 Stephenson Ave, Savannah, GA 31405-5970 | 2020-03-19 |
| 1942833009 | Lauren Brittany Tatum | Nurse Practitioner | 633 Stephenson Ave, Savannah, GA 31405-5970 | 2020-02-18 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1053918441 | Nicole Marie Tetro | Anesthesiology | Candler Hospital, 5353 Reynolds St, Savannah, GA 31405 | 2020-10-08 |
| 1154983880 | Nickes Medical Supply, LLC. | Durable Medical Equipment & Medical Supplies | 6020 Halsey St, Savannah, GA 31405 | 2019-07-02 |
| 1215593025 | Lee Ann Ryle | Nurse Practitioner | 5223 Paulsen St., Savannah, GA 31405 | 2019-05-16 |
| 1942765334 | Raegan Epps | Behavior Technician | 613 Stephenson Ave Ste 205, Savannah, GA 31405 | 2019-02-10 |
| 1679050454 | Phenomenal Nursing Service | Registered Nurse | 604 South St., 604 South St, Savannah, GA 31405 | 2018-07-24 |
| 1275029472 | Chelsea Amanda Keedy | Pharmacist | 836 E. 65th St., Medical Arts #4, Savannah, GA 31405 | 2018-07-11 |
| 1265933840 | Dwc-p LLC | Dentist | 5209 Paulsen Street, Savannah, GA 31405 | 2018-02-28 |
| 1386153005 | Aaron Shaw | Hearing Instrument Specialist | 5501 Abercorn St Ste E, Savannah, GA 31405 | 2017-09-26 |
| 1063946028 | Elizabeth Bentley Bruhn-danello | Dietitian, Registered | 836 East 65th Street, Medical Arts #4, Savannah, GA 31405 | 2017-04-17 |
| 1396278230 | Theresa Lynn George | Health Educator | 836 East 65 Th Street, Medical Arts #4, Savannah, GA 31405 | 2017-04-07 |
| Find all providers in zip 31405 | ||||
| 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 |
|---|---|---|---|---|
| 1326687690 | Lisa Marie Hogan | Nurse Practitioner | 135 Betsy Dr, Savannah, TN 38372-8907 | 2020-01-03 |
| 1619442951 | Leah Jean Carter | Nurse Practitioner | 1309 Trafford Ln, Savannah, GA 31410-5120 | 2018-10-12 |
| 1437761566 | Muscogee Mental Health and Wellness Services LLC | Nurse Practitioner | 9111 White Bluff Rd, Savannah, GA 31406-4606 | 2020-08-19 |
| 1013525005 | Dhariniben Patel | Nurse Practitioner | 1915 Eisenhower Dr, Savannah, GA 31406-5027 | 2020-07-16 |
| 1336775550 | Tshaun Grant | Nurse Practitioner | 633 Stephenson Ave, Savannah, GA 31405-5970 | 2020-03-19 |
| 1720611379 | Emilie Taulbee | Nurse Practitioner | 601 E 66th St, Savannah, GA 31405-4519 | 2020-02-21 |
| 1922631670 | Joseph Anthony Walker | Nurse Practitioner | 601 E 66th St, Savannah, GA 31405-4519 | 2020-02-20 |
| 1942833009 | Lauren Brittany Tatum | Nurse Practitioner | 633 Stephenson Ave, Savannah, GA 31405-5970 | 2020-02-18 |
| 1154817906 | Mary Alice Gillingham | Nurse Practitioner | 1915 Eisenhower Dr, Savannah, GA 31406-5027 | 2018-07-05 |
| 1205246899 | Boles Global Telepsychiatry | Nurse Practitioner | 785 King George Blvd, Suite 101, Savannah, GA 31419-9501 | 2014-05-05 |
| Find all providers in SAVANNAH | ||||
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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.