Brandi Marie Green, R.N.
Individual provider Active NPI Emergency Registered Nurse · Libertyville, IL
NPI 1700936713 · NPPES record last updated Jul 8, 2007
Key facts
- NPI
- 1700936713
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Emergency Registered Nurse 163WE0003X
- Practice address
- 801 S Milwaukee Ave
Libertyville, IL 60048-3204 - Phone
- (847) 990-5300
- NPI assigned
- Jan 11, 2007
- Sex
- Female
- Sole proprietor
- No
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
- Credentials
- Registered Nurse
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 041-343332 | IL | MD | Emergency Registered Nurse |
| RN00151370 | WA | MD | Emergency Registered Nurse |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Emergency Registered Nurse | 163WE0003X | RN00151370 | WA | |
| Emergency Registered Nurse | 163WE0003X | IL | Yes |
Addresses
Primary practice location
801 S Milwaukee Ave
Libertyville, IL 60048-3204
Mailing address
1880 Intrepid St Apt B
Great Lakes, IL 60088-1256
Phone (847) 473-9165
Other providers in Libertyville, IL
- Trysta Allyson Grassel
- Graybridge Health, NFP
- Kenneth J Grayer Jr.
- Grayslake Medical Group, LLC
- Great Lakes Dental P.C.
- Elizabeth Green
- Jill C Green
- Michael Steven Greenbaum
- Stacy Greenberg
- Brenda R Greene
All providers in Libertyville, IL · Emergency Registered Nurse in Illinois
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jul 8, 2007. 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.