Provider Demographics
NPI:1831814821
Name:GREEN, EVE B
Entity type:Individual
Prefix:
First Name:EVE
Middle Name:B
Last Name:GREEN
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3044 STANTON RD SE APT 201
Mailing Address - Street 2:
Mailing Address - City:WASHINGTON
Mailing Address - State:DC
Mailing Address - Zip Code:20020-7879
Mailing Address - Country:US
Mailing Address - Phone:202-766-2448
Mailing Address - Fax:
Practice Address - Street 1:1200 MISSISSIPPI AVE SE APT 226
Practice Address - Street 2:
Practice Address - City:WASHINGTON
Practice Address - State:DC
Practice Address - Zip Code:20032-4443
Practice Address - Country:US
Practice Address - Phone:240-556-3073
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-10-11
Last Update Date:2022-10-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3747P1801XNursing Service Related ProvidersTechnicianPersonal Care Attendant