Evelet Amanda Green, RN

Primary specialty

Registered NurseTaxonomy code 163W00000X

License

R45831 Issued in CT

Practice address

584 Jennings Ave
Bridgeport
Bridgeport, CT 06610-1114

Phone

(203) 371-7652

Fax

(203) 371-7652

NPI assigned

Sep 28, 2009

Sex

Female

Sole proprietor

No

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

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Registered Nurse

State licenses

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

{
    "created_epoch": "1254096000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1254096000000",
    "number": "1063746816",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "584 JENNINGS AVENUE",
            "address_2": "BRIDGEPORT",
            "city": "BRIDGEPORT",
            "state": "CT",
            "postal_code": "06610",
            "telephone_number": "203-371-7652",
            "fax_number": "203-371-7652"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "584 JENNINGS AVE",
            "address_2": "BRIDGEPORT",
            "city": "BRIDGEPORT",
            "state": "CT",
            "postal_code": "066101114",
            "telephone_number": "203-371-7652",
            "fax_number": "203-371-7652"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GREEN",
        "first_name": "EVELET",
        "middle_name": "AMANDA",
        "name_prefix": "Miss",
        "credential": "RN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2009-09-28",
        "last_updated": "2009-09-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "CT",
            "license": "R45831",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Laura J Greco
• Green Lotus Therapy PLLC
• Alexis Green
• Carina L Green
• Dymond Green
• Julie Broderick Green, LCSW MFT MA
• Serena Green, LCSW
• Tremain Green
• Green's Car Service LLC (Green's Car Services)
• Daylan Kendall Greer II, MA

• Registered Nurse in Bridgeport, CT
• Providers in Bridgeport, CT by specialty
• Registered Nurse in Connecticut

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 28, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.