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Individual

MS. DEBRA GREEN

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
MSN, C-FNP

Contact information

Practice address
1524 EUBANK BLVD NE STE 6, ALBUQUERQUE, NM 87112-4160
(505) 503-8600
(888) 503-8511
Mailing address
PO BOX 95590, ALBUQUERQUE, NM 87199-5590
(505) 503-6800
(866) 530-1835

Taxonomy

Speciality
Code
Description
License number
State
208100000X
Physical Medicine & Rehabilitation Physician
CNP00871
NM
363LF0000X
Family Nurse Practitioner
Primary
R39646
NM

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
1114110558
NM
05
58606823
NM
Enumeration date
08/20/2007
Last updated
11/15/2023
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