Abigail Lavinia Green, AGPCNP, DNP

Primary specialty

Gerontology Nurse PractitionerTaxonomy code 363LG0600X

License

SP026725 Issued in PA

Practice address

7604 Central Ave Ste 101
Philadelphia, PA 19111-2433

Phone

(215) 707-3133

NPI assigned

Jan 9, 2023

Last updated

Jan 9, 2023By the provider in NPPES

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)

Enrolled

Credentials

Nurse Practitioner

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

{
    "created_epoch": "1673222400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1673222400000",
    "number": "1912611658",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7604 CENTRAL AVE STE 101",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191112433"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7604 CENTRAL AVE STE 101",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191112433",
            "telephone_number": "215-707-3133"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GREEN",
        "first_name": "ABIGAIL",
        "middle_name": "LAVINIA",
        "name_prefix": "Dr.",
        "credential": "AGPCNP, DNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-01-09",
        "last_updated": "2023-01-09",
        "certification_date": "2023-01-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LG0600X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Gerontology",
            "state": "PA",
            "license": "SP026725",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Green Pharmacy and Store LLC
• Green River Counseling LLC
• Green Transportation Service LLC
• Green Tree School
• Green Tree School
• Aisha Green
• Alyssa Green, M.D.
• Angela Rose Green, RD
• Ariela Green, MD
• Autumn Green

• Gerontology Nurse Practitioner in Philadelphia, PA
• Providers in Philadelphia, PA by specialty
• Gerontology Nurse Practitioner in Pennsylvania

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 9, 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.