Provider Demographics
NPI:1982273736
Name:GREEN, CARRIE (TND)
Entity Type:Individual
Prefix:DR
First Name:CARRIE
Middle Name:
Last Name:GREEN
Suffix:
Gender:F
Credentials:TND
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:849 WYNDEMERE WAY
Mailing Address - Street 2:
Mailing Address - City:NAPLES
Mailing Address - State:FL
Mailing Address - Zip Code:34105-7167
Mailing Address - Country:US
Mailing Address - Phone:239-300-8146
Mailing Address - Fax:
Practice Address - Street 1:849 WYNDEMERE WAY
Practice Address - Street 2:
Practice Address - City:NAPLES
Practice Address - State:FL
Practice Address - Zip Code:34105-7167
Practice Address - Country:US
Practice Address - Phone:239-300-8146
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-06-24
Last Update Date:2022-09-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes175F00000XOther Service ProvidersNaturopath
No171400000XOther Service ProvidersHealth & Wellness Coach
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program