MANDY GREEN (NPI# 1811241292) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1811241292 |
| Entity Type | Individual |
| Full Name | MANDY GREEN |
| Credential | NP-C |
| Practice Address |
910 E Houston St Ste 230 Tyler TX 75702-8369 |
| Mailing Address |
Po Box 846098 Dallas TX 75284-6098 |
| Practice Telephone | 9035257300 |
| Mailing Telephone | 9033246400 |
| Enumeration Date | 2012-11-06 |
| Last Update Date | 2016-02-17 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363L00000X | Nurse Practitioner | AP122656 | TX | Physician Assistants & Advanced Practice Nursing Providers |
| N | 363L00000X | Nurse Practitioner | 679662 | TX | Physician Assistants & Advanced Practice Nursing Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| TX | TEXAS BOARD OF NURSING | 679662 | 01 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1083887376 | Mandy Green | Counselor | 4803 San Felipe St, Houston, TX 77056-3907 | 2008-04-08 |
| Street Address |
910 E HOUSTON ST STE 230 |
| City | TYLER |
| State | TX |
| Zip Code | 75702-8369 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1518962299 | Nina Beth Partin | Physician Assistant | 910 E Houston St, Ste 550, Tyler, TX 75702-8369 | 2005-06-17 |
| 1396212437 | Courtney Elizabeth Clifton | Nurse Practitioner | 910 E Houston St, Tyler, TX 75702-8369 | 2018-10-26 |
| 1275991994 | Good News Medical, Pllc | Family Medicine | 910 E Houston St, Tyler, TX 75702-8369 | 2016-02-09 |
| 1154788941 | April Michelle Coursey | Nurse Practitioner | 910 E Houston St, Ste 550, Tyler, TX 75702-8369 | 2016-01-25 |
| 1417343526 | Dana R Pillans | Nurse Practitioner | 910 E Houston St, Ste 530, Tyler, TX 75702-8369 | 2015-04-15 |
| 1770973844 | Sharon L Brooks | Registered Nurse | 910 E Houston St, Ste. 550, Tyler, TX 75702-8369 | 2015-01-28 |
| 1376948620 | Kirsten Stuber | Nurse Practitioner | 910 E Houston St, Suite 100, Tyler, TX 75702-8369 | 2014-10-29 |
| 1417352931 | Texas Oncology, P.a. | Clinic/Center | 910 E Houston St, Suite 100, Tyler, TX 75702-8369 | 2014-10-27 |
| 1902158751 | Ashley Lesniewski | Nurse Practitioner | 910 E Houston St, Suite 330, Tyler, TX 75702-8369 | 2012-10-03 |
| 1760773709 | Anwar Zaman | Pain Medicine | 910 E Houston St, #230, Tyler, TX 75702 | 2011-04-25 |
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| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1679116610 | Tiffiney Mcmakin | Nurse Practitioner | 810 E Houston St # 100, Tyler, TX 75702 | 2019-10-22 |
| 1659852507 | Krystal Gayle Lilley | Licensed Vocational Nurse | 100 E Ferguson St Ste 60a, Tyler, TX 75702 | 2018-08-28 |
| 1679029383 | Cynthia Lynn Kalawe | Physical Therapist | 100 E Ferguson, Suite 1204, Tyler, TX 75702 | 2016-09-01 |
| 1649623646 | Susan E Oxford | Social Worker | 13495 Frankston Highway, Tyler, TX 75702 | 2016-07-14 |
| 1053769281 | All Kidz Kan | Home Health | 2902 E Front St, Tyler, TX 75702 | 2016-05-27 |
| 1821415639 | Heather Mullins | Physical Therapy Assistant | 100 E. Ferguson Ste.1204, Tyler, TX 75702 | 2014-03-19 |
| 1346671336 | Dennis Keith Johnson | Dentist | 3081 Hwy. 31 East, Tyler, TX 75702 | 2013-12-02 |
| 1275882201 | Bobby Gibson | Counselor | 401 East Front Street, Ste 233, Tyler, TX 75702 | 2012-09-06 |
| 1144596792 | Tina Marie Borke | Clinical Neuropsychologist | 719 West Front St., Tyler, TX 75702 | 2012-03-28 |
| 1457629529 | James Whaley Rapp | Specialist/Technologist | 430 South Beckham Avenue, Trinity Mother Frances Sports Medicine, Tyler, TX 75702 | 2011-12-05 |
| Find all providers in zip 75702 | ||||
| Taxonomy Code | 363L00000X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Nurse Practitioner |
| (1) A registered nurse provider with a graduate degree in nursing prepared for advanced practice involving independent and interdependent decision making and direct accountability for clinical judgment across the health care continuum or in a certified specialty. (2) A registered nurse who has completed additional training beyond basic nursing education and who provides primary health care services in accordance with state nurse practice laws or statutes. Tasks performed by nurse practitioners vary with practice requirements mandated by geographic, political, economic, and social factors. Nurse practitioner specialists include, but are not limited to, family nurse practitioners, gerontological nurse practitioners, pediatric nurse practitioners, obstetric-gynecologic nurse practitioners, and school nurse practitioners. |
| Notes: Source: (1) American Nurses’ Association, American Nurses Credentialing Center, 1996 Certification Catalogue. (2) ) Lexikon: Dictionary of Health Care Terms, Organizations and Acronyms for the Era of Reform, The Joint Commission on Accreditation of Healthcare Organizations, Oakbrook Terrace, Illinois: 1994, p. 549. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1841830601 | David Clay Mcintyre | Nurse Practitioner | 7924 S Broadway Ave Ste 900, Tyler, TX 75703-5252 | 2020-01-09 |
| 1750805941 | Roger Bryan Chapman | Nurse Practitioner | 6115 New Copeland Rd, Tyler, TX 75703 | 2017-07-28 |
| 1477925600 | Brenda Leath Goings | Nurse Practitioner | 703 S Fleishel Ave # 5000, Tyler, TX 75701 | 2015-10-27 |
| 1750708368 | Crossway Family Health Center Pllc | Nurse Practitioner | 6004 South Broadway, Tyler, TX 75703-4424 | 2014-03-20 |
| 1780952580 | Loretta Eve Wilson | Nurse Practitioner | 700 Olympic Plaza Cir Ste 904, Tyler, TX 75701-1958 | 2011-12-07 |
| 1558442376 | Christina Danielle Barnes | Nurse Practitioner | 800 E Dawson St - Hospitalists, Tyler, TX 75701 | 2006-10-18 |
| 1164406773 | Gayle Pegler Varnell | Nurse Practitioner | 3900 University Blvd, Tyler, TX 75799-0001 | 2005-12-06 |
| 1922080076 | Kerry Scruggs | Nurse Practitioner | 3310 Patriot Dr, Tyler, TX 75701-6606 | 2005-11-15 |
| 1003414525 | Abram Ambriz | Nurse Practitioner | 2608 Mcdonald Rd, Tyler, TX 75701-5934 | 2020-10-16 |
| 1396350039 | Lorna Casey Blakney | Nurse Practitioner | 1305 Doctors Dr, Tyler, TX 75701-2263 | 2020-09-10 |
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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.