Individual
MS. KATHY E GREEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
ARNP
Contact information
Practice address
16 PHILLIPS ST, MASSENA, NY 13662-2016
(315) 764-8076
(315) 764-8079
Mailing address
16 PHILLIPS ST, MASSENA, NY 13662-2016
(315) 764-8076
(315) 764-8079
Taxonomy
Speciality
Code
Description
License number
State
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
ARNP9385304
FL
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
F400400
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
Y0NM1
BCBS
FL
Enumeration date
01/05/2006
Last updated
10/10/2023
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