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Individual

GINA ANN GREEN

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
FNP

Contact information

Practice address
401 W MAIN ST STE 1810, LOUISVILLE, KY 40202-2927
(888) 349-1116
Mailing address
12201 BLUEGRASS PKWY, LOUISVILLE, KY 40299-2361
(502) 568-7364
(502) 568-7136

Taxonomy

Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
0032484
OH
363L00000X
Nurse Practitioner
237336
LA
363L00000X
Nurse Practitioner
3-001853
AL
363L00000X
Nurse Practitioner
Primary
3011037
KY
363L00000X
Nurse Practitioner
71014463A
IN
363L00000X
Nurse Practitioner
GAA-NP002452
GA
363LF0000X
Family Nurse Practitioner
3011037
KY

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
3011037
KY NP LICENSE
KY
Enumeration date
02/20/2018
Last updated
10/21/2025
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