Individual
KIMBERLY ANN GREEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CRNP
Contact information
Practice address
300 PINE GROVE CMNS, YORK, PA 17403-5176
(717) 851-6110
(717) 741-1076
Mailing address
3421 CONCORD RD, YORK, PA 17402-9001
(717) 851-6110
(717) 741-1076
Taxonomy
Speciality
Code
Description
License number
State
363LA2200X
Adult Health Nurse Practitioner
Primary
TP002141C
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1586612
GATEWAY-WMG
PA
01
—
2132382
HIGHMARK FREEDOM BLUE
PA
01
—
956320
CAREFIRST MD BCBS
PA
Enumeration date
07/27/2009
Last updated
09/28/2022
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