Individual
MRS. STEPHANIE L GREEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CFNP
Contact information
Practice address
450 TATONE ST, BOARDMAN, OR 97818-8076
(541) 481-7212
(541) 481-2020
Mailing address
PO BOX 397, BOARDMAN, OR 97818-0397
(541) 481-7212
(541) 481-5447
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
804976
MS
363LF0000X
Family Nurse Practitioner
Primary
2066
NE
363LF0000X
Family Nurse Practitioner
APN.0992934-NP
CO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
07358266
—
MS
Enumeration date
03/30/2006
Last updated
04/21/2025
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