Individual
DORA RENEE GREEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CRNA
Contact information
Practice address
132 ABIGAIL LN, PORT MATILDA, PA 16870-7153
(814) 272-5011
(814) 272-6531
Mailing address
100 N ACADEMY AVE STE 6&7, DANVILLE, PA 17822-4903
(814) 272-5011
(814) 272-6531
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
209.013944
IL
367500000X
Certified Registered Nurse Anesthetist
Primary
RN264780
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000196948
ANTHEM BLUE SHIELD
—
01
—
000001092366
ANTHEM PROVIDER NUMBER
IN
05
—
200371350
—
IN
05
—
2247661
—
OH
05
—
300004136
—
IN
01
—
617576
WELLCARE
KY
01
—
728022
BUCKEYE
—
05
—
74006495
—
KY
Enumeration date
12/30/2005
Last updated
03/09/2026
About Stedi
Stedi is the only programmable healthcare clearinghouse. You can use Stedi's APIs to process eligibility checks, claims, remits, and more.
Contact us