Provider Demographics
NPI:1164822409
Name:GREEN, KAREN LEAH (CRNP-PMH)
Entity Type:Individual
Prefix:MRS
First Name:KAREN
Middle Name:LEAH
Last Name:GREEN
Suffix:
Gender:F
Credentials:CRNP-PMH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8114 SANDPIPER CIRCLE
Mailing Address - Street 2:SUITE 215
Mailing Address - City:BALTIMORE
Mailing Address - State:MD
Mailing Address - Zip Code:21236
Mailing Address - Country:US
Mailing Address - Phone:410-933-9000
Mailing Address - Fax:410-933-0125
Practice Address - Street 1:8114 SANDPIPER CIRCLE
Practice Address - Street 2:SUITE 215
Practice Address - City:BALTIMORE
Practice Address - State:MD
Practice Address - Zip Code:21236
Practice Address - Country:US
Practice Address - Phone:410-933-9000
Practice Address - Fax:410-933-0125
Is Sole Proprietor?:No
Enumeration Date:2014-08-22
Last Update Date:2016-08-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDR188329363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health