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Individual

HEIDI LOUISE GREEN

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
M.D.

Taxonomy

Speciality
Code
Description
License number
State
2084P0800X
Psychiatry Physician
Primary
200300796
NC

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
134VC
BCBS
NC
01
2018243A
MEDICARE
NC
01
477015
HUMANA GOLD CHOICE
05
89134VC
NC
Enumeration date
07/19/2006
Last updated
04/01/2010
Update your record

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