Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 363LF0000X | Nurse Practitioner - Family Medicine | 201050180 | OR |
N | 363LF0000X | Nurse Practitioner - Family Medicine | 22604.1078 | WY |
Y | 363LP0808X | Nurse Practitioner - Psychiatric/Mental Health | 201700657NP | OR |
N | 363LP0808X | Nurse Practitioner - Psychiatric/Mental Health | 22604.1078 | WY |
NPI | 1023326741 |
---|---|
Provider Name | Mrs. Christy J. Green |
First Address | Eugene, OR 97401-3570 |
Second Address | Eugene, OR 97401-3570 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 15/09/2010 |
Last Update Date | 12/03/2019 |