Laketa Green

Primary specialty

Community/Behavioral Health AgencyTaxonomy code 251S00000X

Practice address

7320 S Rainbow Blvd # 102-192
Las Vegas, NV 89139-0406

Phone

(702) 625-1079

NPI assigned

May 18, 2023

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

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

{
    "created_epoch": "1684368000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1686355200000",
    "number": "1902597057",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7320 S RAINBOW BLVD # 102-192",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891390406",
            "telephone_number": "702-625-1079"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7320 S RAINBOW BLVD # 102-192",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891390406",
            "telephone_number": "702-625-1079"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GREEN",
        "first_name": "LAKETA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2023-05-18",
        "last_updated": "2023-06-10",
        "certification_date": "2023-06-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Kimberly Green, MSN, FNP-BC
• Kimberly Marie Green
• Krystal L Green
• Ky-Aujah Green
• L'Tanya Denise Green, LBSW
• Latycia Green
• Laura Ann Green
• Linda Green
• Lovena Marie Green
• Markeisha Shanique Green

• Community/Behavioral Health Agency in Las Vegas, NV
• Providers in Las Vegas, NV by specialty
• Community/Behavioral Health Agency in Nevada

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 10, 2023; 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.