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Organization

EVERGREEN WOMENS HEALTH CARE PLLC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
ALAN J GREEN M.D. (OWNER)
(603) 882-0555
Entity
Organization

Contact information

Practice address
280 MAIN ST, SUITE 131, NASHUA, NH 03060-2919
(603) 882-0555
(603) 882-0360
Mailing address
280 MAIN ST, SUITE 131, NASHUA, NH 03060-2919
(603) 882-0555
(603) 882-0360

Taxonomy

Speciality
Code
Description
License number
State
207V00000X
Obstetrics & Gynecology Physician
Primary
207VE0102X
Reproductive Endocrinology Physician
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
363LW0102X
Women's Health Nurse Practitioner
363LX0001X
Obstetrics & Gynecology Nurse Practitioner

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
30212533
NH
01
30D1022401
CLIA
NH
01
3407428
AETNA HEALTHCARE
NH
01
696747
TUFTS HEALTH PLAN
MA
01
701468000
MAGELLAN BEHAVIORAL
NH
01
80031
HEALTHSOURCE
NH
01
M18351
BCBSMA
MA
Enumeration date
03/19/2006
Last updated
09/28/2009
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