Individual
TIFFINY SHANTAY GREEN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
APN
Contact information
Practice address
417 WARREN ST UNIT 373, BEVERLY, NJ 08010-1100
(609) 227-1970
Mailing address
417 WARREN ST UNIT 373, BEVERLY, NJ 08010-1100
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
26NR15665200
NJ
363LF0000X
Family Nurse Practitioner
26NJ00685600
NJ
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
2023061499
NJ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0543934
—
NJ
Enumeration date
01/10/2014
Last updated
03/05/2025
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