Mary Christine Green, RN, PCNS-BC

Primary specialty

Pediatric Registered NurseTaxonomy code 163WP0200X

License

079924 Issued in MO

Practice address

1465 S Grand Blvd
Saint Louis, MO 63104-1003

Phone

(314) 577-5392

Fax

(314) 268-6441

NPI assigned

Nov 1, 2012

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

Other names 1

• M Christine Green Professional name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner, Registered Nurse

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

{
    "created_epoch": "1351728000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1351728000000",
    "number": "1184978892",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1465 S GRAND BLVD",
            "city": "SAINT LOUIS",
            "state": "MO",
            "postal_code": "631041003",
            "telephone_number": "314-577-5392",
            "fax_number": "314-268-6441"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1465 S GRAND BLVD",
            "city": "SAINT LOUIS",
            "state": "MO",
            "postal_code": "631041003",
            "telephone_number": "314-577-5392",
            "fax_number": "314-268-6441"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GREEN",
        "first_name": "MARY",
        "middle_name": "CHRISTINE",
        "credential": "RN, PCNS-BC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2012-11-01",
        "last_updated": "2012-11-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163WP0200X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Pediatrics",
            "state": "MO",
            "license": "079924",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "M",
            "last_name": "GREEN",
            "middle_name": "CHRISTINE",
            "credential": "RN, PCNS-BC",
            "code": "2",
            "type": "Professional Name"
        }
    ]
}

• Kimberley A Green, PH.D., HSPP
• Kourtenay V Green, D.D.S.
• Latreisha Green
• Laura Ellen Green
• Laura Germaine Green, OTR
• Green, Maxville, and Associates
• Michael Green, MD
• Molly Jane Green, MA
• Percy Green II
• Poetrii Green

• Pediatric Registered Nurse in Saint Louis, MO
• Providers in Saint Louis, MO by specialty
• Pediatric Registered Nurse in Missouri

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 1, 2012; 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.