SHANA R GREEN (NPI# 1861761207) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1861761207 |
| Entity Type | Individual |
| Full Name | SHANA R GREEN |
| Credential | PMHNP-BC/ ANP-BC |
| Practice Address |
1155 Alpine Ave Fl 2 Boulder CO 80304 |
| Mailing Address |
1155 Alpine Ave Fl 2 Boulder CO 80304-3495 |
| Practice Telephone | 3034154299 |
| Practice Fax Number | 3034412202 |
| Mailing Telephone | 3034154299 |
| Mailing Fax Number | 3034412202 |
| Enumeration Date | 2011-12-14 |
| Last Update Date | 2018-05-22 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 163W00000X | Registered Nurse | RN.1650946 | CO | Nursing Service Providers |
| N | 163W00000X | Registered Nurse | 708000 | CA | Nursing Service Providers |
| N | 363LA2200X |
Nurse Practitioner Specialization: Adult Health |
21009 | CA | Physician Assistants & Advanced Practice Nursing Providers |
| Y | 363LP0808X |
Nurse Practitioner Specialization: Psych/Mental Health |
APN.0993439-NP | CO | Physician Assistants & Advanced Practice Nursing Providers |
| N | 363LP0808X |
Nurse Practitioner Specialization: Psych/Mental Health |
21009 | CA | Physician Assistants & Advanced Practice Nursing Providers |
| Address | Telephone Number | Fax Number |
|---|---|---|
| 1000 W South Boulder Rd Ste 110, Lafayette, CO 800262753 | 3034154355 | 3036661982 |
| Street Address |
1155 ALPINE AVE FL 2 |
| City | BOULDER |
| State | CO |
| Zip Code | 80304 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1720605256 | Evol.v Chiropractic LLC | Chiropractor | 2401 Broadway #208, Boulder, CO 80304 | 2020-07-01 |
| 1760038723 | Patrica Anne Zeyher | Counselor | 100 Alpine Ave., Boulder, CO 80304 | 2019-08-15 |
| 1356855928 | Opal Counseling Center, LLC | Counselor | 1480 Lee Hill Dr. #7, Boulder, CO 80304 | 2017-11-19 |
| 1831608603 | Lesley Ann Cloke | Dietitian, Registered | 1895 Bluff St., Unit C, Boulder, CO 80304 | 2017-09-25 |
| 1790209740 | Megan Litwiller | Occupational Therapist | 810 Maxwell Ave, Boulder, CO 80304 | 2017-08-01 |
| 1285163774 | Nadine Martin | Registered Nurse | 311 Mapleton Ave # 331, Boulder, CO 80304 | 2017-06-08 |
| 1598119281 | Megan Cronin Larson | Social Worker | 825 S. Broadway Street, Boulder, CO 80304 | 2016-04-19 |
| 1760844237 | Rafia Rebeck | Counselor | 1235 Elder Ave #7, Boulder, CO 80304 | 2016-03-24 |
| 1629441688 | Jennifer S Delaney | Counselor | 2334 Broadway, Ste. B, Boulder, CO 80304 | 2015-11-12 |
| 1891162301 | Kingston Dialysis LLC | Clinic/Center | 2880 Folsom St Ste 110, Boulder, CO 80304 | 2015-09-01 |
| Find all providers in zip 80304 | ||||
| Taxonomy Code | 363LP0808X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Nurse Practitioner |
| Specialization | Psych/Mental Health |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1659911907 | Ascent Mental Health | Nurse Practitioner | 5350 Manhattan Cir Ste 201, Boulder, CO 80303-4272 | 2020-01-14 |
| 1437709987 | Shadow Mountain Mental Health | Nurse Practitioner | 6658 Gunpark Dr Ste 201a, Boulder, CO 80301-3375 | 2019-09-17 |
| 1871151308 | Mountain Psychiatry | Nurse Practitioner | 1905 15th St Unit 489, Boulder, CO 80302-5413 | 2019-05-30 |
| 1083990121 | Lindsay Regnery Burke | Nurse Practitioner | 1621 16th St, Boulder, CO 80302-6325 | 2011-11-02 |
| 1750557385 | Linda Geralyn Buseman | Nurse Practitioner | Wardenburg Health Center Php, 119 Ucb, Boulder, CO 80309-0001 | 2008-05-04 |
| 1881681120 | Anne Elizabeth Miller | Nurse Practitioner | 1900 Wardenburg Dr., 119 Ucb, Boulder, CO 80309 | 2005-10-03 |
| 1982606521 | Karen Breunig Hine | Nurse Practitioner | 1333 Iris Ave, Boulder, CO 80304-2226 | 2005-08-12 |
| 1871139337 | Antonio Stone | Nurse Practitioner | 4770 Baseline Rd Ste 200, Boulder, CO 80303-2668 | 2019-11-20 |
| 1396390480 | Susan Renae Hudson | Nurse Practitioner | 5277 Manhattan Cir Ste 220, Boulder, CO 80303-8201 | 2019-08-06 |
| 1093134579 | Michelle Angela Fisher | Nurse Practitioner | 1155 Alpine Ave Ste 385, Boulder, CO 80304-3422 | 2014-04-10 |
| Find all providers in BOULDER | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.