Ellen Louise Green-Young, RD/LD
Individual provider Active NPI Registered Dietitian · Wright City, OK
NPI 1447513858 · NPPES record last updated Jun 20, 2012
Key facts
- NPI
- 1447513858
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Registered Dietitian 133V00000X
- License
- 879 (OK)
- Practice address
- 670 Petunia Road
Wright City, OK 74766 - Phone
- (580) 236-3705
- Fax
- (580) 981-7005
- NPI assigned
- Jun 20, 2012
- Sex
- Female
- Sole proprietor
- Yes
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 |
|---|---|---|---|
| 879 | OK | MD | Registered Dietitian |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Registered Dietitian | 133V00000X | 879 | OK | Yes |
Addresses
Primary practice location
670 Petunia Road
Wright City, OK 74766
Mailing address
PO Box 100
Wright City, OK 74766-0100
Phone (580) 236-3705
Other providers in Wright City, OK
- Karen Ann Crosby
- Sara Joycelyn Devore
- Shami Lynn Fowler
- Good Honest Medicine
- Darla Gene Grayson
- Shelby Harris
- Todd Keyes
- Lane Family Clinic
- Lane Family Clinic LLC
- Karyn Rebecca Lane
All providers in Wright City, OK · Registered Dietitian in Oklahoma
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jun 20, 2012. 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.