Provider Demographics
NPI:1295202745
Name:GREEN, ELIZABETH TURNBULL (RN)
Entity Type:Individual
Prefix:MS
First Name:ELIZABETH
Middle Name:TURNBULL
Last Name:GREEN
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:704 EDWARDS AVE
Mailing Address - Street 2:
Mailing Address - City:WESTCLIFFE
Mailing Address - State:CO
Mailing Address - Zip Code:81252-8588
Mailing Address - Country:US
Mailing Address - Phone:719-783-3369
Mailing Address - Fax:719-789-3336
Practice Address - Street 1:704 EDWARDS AVE
Practice Address - Street 2:
Practice Address - City:WESTCLIFFE
Practice Address - State:CO
Practice Address - Zip Code:81252-8588
Practice Address - Country:US
Practice Address - Phone:719-783-3369
Practice Address - Fax:719-789-3336
Is Sole Proprietor?:No
Enumeration Date:2018-11-01
Last Update Date:2018-11-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO0160785163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse