Individual
MS. PHYLLIS R GREEN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
WHCNP
Contact information
Practice address
3425 1ST AVE SE, SUITE 100, CEDAR RAPIDS, IA 52402-6155
(319) 363-3459
Mailing address
3425 1ST AVE SE, SUITE 100, CEDAR RAPIDS, IA 52402-6155
(319) 363-3459
Taxonomy
Speciality
Code
Description
License number
State
363LW0102X
Women's Health Nurse Practitioner
Primary
F-076357
IA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
07-12543
MEDICA
—
05
—
095817400
—
MN
05
—
10025013500
—
NE
01
—
1017855
PREFERRED ONE
—
01
—
1043738
AMERICA'S PPO (ARAZ)
—
01
—
122187
UCARE
—
01
—
23511
SIOUX VALLEY HEALTH PLAN
—
01
—
32B01BE
BCBS MN
MN
01
—
4998568
BCBS SD (WELLMARK)
SD
01
—
4998913
BCBS SD (WELLMARK)
SD
05
—
6826080
—
SD
05
—
6826082
—
SD
01
—
HP39675
HEALTH PARTNERS
—
Enumeration date
01/24/2006
Last updated
11/10/2010
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