Tabatha Green, LPN

Primary specialty

Licensed Practical NurseTaxonomy code 164W00000X

License

4703109730 Issued in MI

Practice address

1221 East Brand Blvd
Detroit, MI 48211

Phone

(734) 458-4601

NPI assigned

Nov 21, 2017

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

State licenses

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

{
    "created_epoch": "1511222400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1511222400000",
    "number": "1528572930",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "15740 COYLE ST",
            "city": "DETROIT",
            "state": "MI",
            "postal_code": "482272623",
            "telephone_number": "313-918-9306"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1221 EAST BRAND BLVD",
            "city": "DETROIT",
            "state": "MI",
            "postal_code": "48211",
            "telephone_number": "734-458-4601"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GREEN",
        "first_name": "TABATHA",
        "credential": "LPN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-11-21",
        "last_updated": "2017-11-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "164W00000X",
            "taxonomy_group": "",
            "desc": "Licensed Practical Nurse",
            "state": "MI",
            "license": "4703109730",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Morgan Green, M.D.
• Nandi Green
• Santana Manuel Green
• Sherry Green
• Simona R Green, LLPC
• Tammy Green, BSW, MHRM
• Tedean Karissa Green
• Tracey Louise Green, PMHNP
• Tremel Green, MSW
• Tylia Green, LMSW

• Licensed Practical Nurse in Detroit, MI
• Providers in Detroit, 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 Nov 21, 2017; 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.