Green, James D

Green, James D is an individual health care provider with primary practice located at 1216 W Main St , Festus MO 63028-1654. He recently has 2 registered licenses in different health care specialties including Physician Assistants & Advanced Practice Nursing Providers / Family, Physician Assistants & Advanced Practice Nursing Providers / Nurse Practitioner. Physician Assistants & Advanced Practice Nursing Providers / Nurse Practitioner is his primary health care specialty. Green, James D can be contacted via phone (636) 543-7600.

Contact Information

Primary practice address
1216 W Main St Festus MO 63028-1654
Phone: (636) 543-7600
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Family 363LF0000X 53-78679-061 Kansas
Physician Assistants & Advanced Practice Nursing Providers / Family 363LF0000X 2021035759 Missouri
Physician Assistants & Advanced Practice Nursing Providers / Nurse Practitioner 363L00000X 2021035759 Missouri

Profile Details

NPI number 1902369671
LBN Legal business name Green, James D
Credentials Family Nurse Practitioner (FNP)
Entity Individual
Sole proprietor 1 No
Enumeration date Apr 10th, 2019
Last updated Nov 8th, 2021 - about 5 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.

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Identifiers

StateTypeNumberIssuer
All States NPI 1902369671 NPPES
Kansas Other 53-78679-061 KANSAS LICENSE NUMBER

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