Green, Dora Renee

Green, Dora Renee is an individual health care provider with primary practice located at 2600 Greenbush St , Lafayette IN 47904-2477. She recently has only one registered license in Physician Assistants & Advanced Practice Nursing Providers / Nurse Anesthetist, Certified Registered, which is considered as her primary health care specialty. Green, Dora Renee can be contacted via phone (765) 448-8000.

Contact Information

Primary practice address
2600 Greenbush St Lafayette IN 47904-2477
Phone: (765) 448-8000
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Nurse Anesthetist, Certified Registered 367500000X 209.013944 Illinois

Profile Details

NPI number 1245217124
LBN Legal business name Green, Dora Renee
Credentials Certified Registered Nurse Anesthetist (CRNA)
Entity Individual
Sole proprietor 1 No
Enumeration date Dec 30th, 2005
Last updated Jul 21st, 2022 - about 4 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

Request for update

Identifiers

StateTypeNumberIssuer
All States NPI 1245217124 NPPES
Ohio MEDICAID 2247661
Ohio Other 728022
Ohio MEDICAID 74006495
Ohio Other 000001092366
Ohio Other 000000196948
Ohio MEDICAID 300004136
Ohio Other 617576
Ohio MEDICAID 200371350

Popular Providers