Provider Demographics
NPI:1316189368
Name:GREEN, DORCAS N (RN)
Entity Type:Individual
Prefix:
First Name:DORCAS
Middle Name:N
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 1:2081 NORTON ST
Mailing Address - Street 2:#6H
Mailing Address - City:ROCHESTER
Mailing Address - State:NY
Mailing Address - Zip Code:14609-2422
Mailing Address - Country:US
Mailing Address - Phone:585-442-5584
Mailing Address - Fax:
Practice Address - Street 1:2081 NORTON ST
Practice Address - Street 2:#6H
Practice Address - City:ROCHESTER
Practice Address - State:NY
Practice Address - Zip Code:14609-2422
Practice Address - Country:US
Practice Address - Phone:585-442-5584
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-04-06
Last Update Date:2009-04-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY600424-1163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse