Nyssa Green, LIC.AC.
Individual provider Active NPI Acupuncturist · Montpelier, VT
NPI 1407338403 · NPPES record last updated Jul 19, 2023
Key facts
- NPI
- 1407338403
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Acupuncturist 171100000X
- License
- 091.0134011 (VT)
- Practice address
- 250 Main St Ste 304
Montpelier, VT 05602-4257 - Phone
- (802) 552-0615
- NPI assigned
- Sep 5, 2018
- Sex
- Female
- Sole proprietor
- No
Organizations & group practices 2
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 091.0134011 | VT | MD | Acupuncturist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Green Dragon Medicine LLC | Acupuncturist | Current |
Accepting new patients |
| Julie Suarez Cormier, Licac, L3C | Acupuncturist | Past | Accepting new patients |
Locations
67 Pearl St
Burlington, VT 05401
250 Main St
Ste 304
Montpelier, VT 05602
Phone (802) 552-0615
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Acupuncturist | 171100000X | 091.0134011 | VT | Yes |
Addresses
Primary practice location
250 Main St Ste 304
Montpelier, VT 05602-4257
Mailing address
250 Main St Ste 304
Montpelier, VT 05602-4257
Phone (802) 552-0615
Other providers in Montpelier, VT
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jul 19, 2023. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.