Is this information incorrect? This page shows public data from NPPES. Update your record in NPPES and this page will update automatically within 7 days.
Individual
BROOKLYN WALSH GREEN
Active
Individual
BROOKLYN WALSH GREEN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PA-C
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
12179
GA
363A00000X
Physician Assistant
PA9114960
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
12179
GEORGIA MEDICAL LICENSE NO.
GA
01
—
PA9114960
FLORIDA MEDICAL LICENSE NO.
FL
Enumeration date
03/24/2021
Last updated
04/20/2024
About Stedi
Stedi is the only programmable healthcare clearinghouse. You can use Stedi's APIs to process eligibility checks, claims, remits, and more.
Sign upProduct
Developers