Provider Demographics
NPI:1457504037
Name:GREEN, JAMIE N (APRN)
Entity Type:Individual
Prefix:MRS
First Name:JAMIE
Middle Name:N
Last Name:GREEN
Suffix:
Gender:F
Credentials:APRN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2510 FRANKLIN WOODS DR
Mailing Address - Street 2:
Mailing Address - City:CONROE
Mailing Address - State:TX
Mailing Address - Zip Code:77304-1655
Mailing Address - Country:US
Mailing Address - Phone:936-615-4563
Mailing Address - Fax:936-462-7772
Practice Address - Street 1:100 MEDICAL CENTER PKWY STE 1000
Practice Address - Street 2:
Practice Address - City:HUNTSVILLE
Practice Address - State:TX
Practice Address - Zip Code:77340-4966
Practice Address - Country:US
Practice Address - Phone:936-295-8000
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-10-28
Last Update Date:2021-09-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXAP117267363L00000X
TX712823363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner