Tashunda Latrese Green, RN

Primary specialty

Neonatal Intensive Care Registered NurseTaxonomy code 163WN0002X

License

041310372 Issued in IL

Practice address

17830 Larkspur LN
Homewood, IL 60430-1131

Phone

(708) 799-6740

NPI assigned

Jun 4, 2008

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

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Registered Nurse

State licenses

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

{
    "created_epoch": "1212537600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1212537600000",
    "number": "1881853992",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "17830 LARKSPUR LN",
            "city": "HOMEWOOD",
            "state": "IL",
            "postal_code": "604301131",
            "telephone_number": "708-799-6740"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "17830 LARKSPUR LN",
            "city": "HOMEWOOD",
            "state": "IL",
            "postal_code": "604301131",
            "telephone_number": "708-799-6740"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GREEN",
        "first_name": "TASHUNDA",
        "middle_name": "LATRESE",
        "name_prefix": "Ms.",
        "credential": "RN",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2008-06-04",
        "last_updated": "2008-06-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163WN0002X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Neonatal Intensive Care",
            "state": "IL",
            "license": "041310372",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• David Edmund Gottlieb, PH.D.
• Yvonne Grandberry
• Great Hands Home Services LLC
• Elisa N Green, M.A., CCC-SLP
• Maurissa Green, MED, BA, PEL
• Deborah Greenberg, OTRL
• Terrance Greene
• William Paul Gress, D.C.
• Jessica Tiffany Griffin
• Millicent Denise Griffin

• Neonatal Intensive Care Registered Nurse in Homewood, IL
• Providers in Homewood, IL by specialty
• Neonatal Intensive Care Registered Nurse in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 4, 2008; 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.