Individual
STEPHANIE P GREEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
APN, FNP
Contact information
Practice address
1801 W WINDSOR RD, CHAMPAIGN, IL 61822-6217
(217) 366-8130
Mailing address
611 W PARK ST, FAPC, URBANA, IL 61801
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
209017535
IL
363LF0000X
Family Nurse Practitioner
209017535
IL
Other
Enumeration date
05/10/2018
Last updated
04/08/2026
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