Hattie Green, LPN

Primary specialty

Licensed Practical NurseTaxonomy code 164W00000X

License

4703018226 Issued in MI

Practice address

2766 W 11 Mile Rd
Suite 2
Berkley, MI 48072-3033

Phone

(248) 542-2424

Fax

(248) 542-5621

NPI assigned

Oct 30, 2015

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

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1446163200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1446163200000",
    "number": "1174995096",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2766 W 11 MILE RD",
            "address_2": "SUITE 2",
            "city": "BERKLEY",
            "state": "MI",
            "postal_code": "480723033",
            "telephone_number": "248-542-2424",
            "fax_number": "248-542-5621"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2766 W 11 MILE RD",
            "address_2": "SUITE 2",
            "city": "BERKLEY",
            "state": "MI",
            "postal_code": "480723033",
            "telephone_number": "248-542-2424",
            "fax_number": "248-542-5621"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GREEN",
        "first_name": "HATTIE",
        "name_prefix": "Ms.",
        "credential": "LPN",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2015-10-30",
        "last_updated": "2015-10-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "164W00000X",
            "taxonomy_group": "",
            "desc": "Licensed Practical Nurse",
            "state": "MI",
            "license": "4703018226",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Richard E Gordon, D.O.
• Chethana Chandrupatla Gottam, M.D.
• Kaylene Graham, LPN
• Christine Grant
• Sarafin Grceski, PA-C
• Julia Beth Greenbaum, LMSW
• Allison Greene
• Courtney Greulich
• Sophelia Ernestine Griffin
• Sujana Gundlapalli, M.D.

• Licensed Practical Nurse in Berkley, MI
• Providers in Berkley, MI by specialty
• Licensed Practical Nurse in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 30, 2015; 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.