G. Lynn Green, APNP

Primary specialty

Nurse PractitionerTaxonomy code 363L00000X

License

1221-033 Issued in WI

Practice address

825 Challenger Dr
Green Bay, WI 54311-8328

Phone

(920) 469-1313

NPI assigned

Apr 17, 2006

Last updated

Mar 7, 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

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Prevea Regional Services, Inc.

  dba Prevea Regional

  • Family Medicine Physician
  • Green Bay, WI
  • NPI 1194748061
  NPD (past)

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

{
    "created_epoch": "1145232000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1678147200000",
    "number": "1992769897",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "825 CHALLENGER DR",
            "city": "GREEN BAY",
            "state": "WI",
            "postal_code": "543118328",
            "telephone_number": "920-469-1313",
            "fax_number": "920-469-4428"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "825 CHALLENGER DR",
            "city": "GREEN BAY",
            "state": "WI",
            "postal_code": "543118328",
            "telephone_number": "920-469-1313"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GREEN",
        "first_name": "G.",
        "middle_name": "LYNN",
        "credential": "APNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-04-17",
        "last_updated": "2023-03-07",
        "certification_date": "2022-08-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "WI",
            "license": "1221-033",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "43908300",
            "state": "WI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Green Meadows Assisted Living LLC
• Green Ride LLC
• Green River Trans LLC
• Alex Jonathan Green, CAA
• Carli Green, DC
• Katherine A. Green, M.D.
• Katie Rose Green
• Sean Green
• Dawn Marie Greenawald
• Greenbayctd LLC

• Nurse Practitioner in Green Bay, WI
• Providers in Green Bay, WI by specialty
• Nurse Practitioner in Wisconsin

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 7, 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.