Green, Chade B

Green, Chade B is an individual health care provider with primary practice located at 1600 North Main , Lovington NM 88260-2830. He recently has 2 registered licenses in different health care specialties including Physician Assistants & Advanced Practice Nursing Providers / Medical, Physician Assistants & Advanced Practice Nursing Providers / Surgical. Physician Assistants & Advanced Practice Nursing Providers / Medical is his primary health care specialty. Green, Chade B can be contacted via phone (575) 396-6611.

Contact Information

Primary practice address
1600 North Main Lovington NM 88260-2830
Phone: (575) 396-6611
Fax: (575) 396-1454
Website:
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Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Medical 363AM0700X 5647 Arizona
Physician Assistants & Advanced Practice Nursing Providers / Medical 363AM0700X PA2014-0082 New Mexico
Physician Assistants & Advanced Practice Nursing Providers / Surgical 363AS0400X 5647 Arizona

Profile Details

NPI number 1093130783
LBN Legal business name Green, Chade B
Credentials Physician's Assistant Certified (PA-C)
Entity Individual
Sole proprietor 1 No
Enumeration date Mar 4th, 2014
Last updated May 11th, 2017 - about 8 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1093130783 NPPES
New Mexico MEDICAID 74921533

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