Provider Demographics
NPI:1770256166
Name:GREEN, ABRIA A (NP)
Entity Type:Individual
Prefix:
First Name:ABRIA
Middle Name:A
Last Name:GREEN
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:ABRIA
Other - Middle Name:A
Other - Last Name:GREEN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:324 MAIN ST UNIT 604
Mailing Address - Street 2:
Mailing Address - City:LAUREL
Mailing Address - State:MD
Mailing Address - Zip Code:20725-7526
Mailing Address - Country:US
Mailing Address - Phone:240-565-8431
Mailing Address - Fax:
Practice Address - Street 1:9520 BERGER RD STE 212
Practice Address - Street 2:
Practice Address - City:COLUMBIA
Practice Address - State:MD
Practice Address - Zip Code:21046-1543
Practice Address - Country:US
Practice Address - Phone:240-565-8431
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-07-30
Last Update Date:2024-03-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDR219515363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health