Mimoka Green

Primary specialty

Licensed Vocational NurseTaxonomy code 164X00000X

License

343789 Issued in TX

Practice address

2404 Limestone TRL
Harker Heights, TX 76548-8909

Phone

(318) 792-7004

NPI assigned

Aug 28, 2018

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

State licenses

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

{
    "created_epoch": "1535414400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1535414400000",
    "number": "1932680816",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4410 OAK VISTA CIR",
            "city": "KILLEEN",
            "state": "TX",
            "postal_code": "765424616",
            "telephone_number": "318-792-7004"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2404 LIMESTONE TRL",
            "city": "HARKER HEIGHTS",
            "state": "TX",
            "postal_code": "765488909",
            "telephone_number": "318-792-7004"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GREEN",
        "first_name": "MIMOKA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2018-08-28",
        "last_updated": "2018-08-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "164X00000X",
            "taxonomy_group": "",
            "desc": "Licensed Vocational Nurse",
            "state": "TX",
            "license": "343789",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Fay Nero Green, LPC
• Lacey Jane Griffel
• Brian Griswold, PA
• Naemi Mendoza Gunter, PT
• H-E-B, LP (HEB Pharmacy #381)
• Haider Capital Holding Corporation (Dkin Deep)

• Licensed Vocational Nurse in Harker Heights, TX
• Providers in Harker Heights, TX by specialty
• Licensed Vocational Nurse in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 28, 2018; 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.