Nichole Marie Green, ARNP

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

AP61208028 Issued in WA

Practice address

8656 W Gage Blvd Ste B203
Kennewick, WA 99336-1154

Phone

(509) 579-0109

Fax

(509) 420-9851

NPI assigned

Aug 19, 2021

Sex

Female

Sole proprietor

Yes

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in WA

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Physicians Immediate Care & Medical Centers, P.S.

  • Family Medicine Physician
  • Richland, WA
  • NPI 1821002510
  Medicare reassignment NPD

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1629331200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1768176000000",
    "number": "1003582974",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8656 W GAGE BLVD STE B203",
            "city": "KENNEWICK",
            "state": "WA",
            "postal_code": "993361154",
            "telephone_number": "509-579-0109",
            "fax_number": "509-420-9851"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8656 W GAGE BLVD STE B203",
            "city": "KENNEWICK",
            "state": "WA",
            "postal_code": "993361154",
            "telephone_number": "509-579-0109",
            "fax_number": "509-420-9851"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GREEN",
        "first_name": "NICHOLE",
        "middle_name": "MARIE",
        "credential": "ARNP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2021-08-19",
        "last_updated": "2026-01-12",
        "certification_date": "2026-01-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "WA",
            "license": "AP61208028",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Colton Gray
• Haylee Ann Gray, LMP
• Tarra Lee Gray, LMP
• Greater Columbia Accountable Community of Health
• Monyay Green, M ED
• Greenbridge Health Clinic
• Christina April Greenough, SUDPT
• Gregory Dorsett, PLLC
• Lisa Kay Griffen, LMT
• Anna Valerie Griffith

• Family Nurse Practitioner in Kennewick, WA
• Providers in Kennewick, WA by specialty
• Family Nurse Practitioner in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 12, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.