Green, Debra

Green, Debra is an sole proprietor health care provider with primary practice located at 1524 Eubank Blvd Ne Ste 6 , Albuquerque NM 87112-4160. She recently has 2 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Physical Medicine & Rehabilitation, Physician Assistants & Advanced Practice Nursing Providers / Family. Physician Assistants & Advanced Practice Nursing Providers / Family is her primary health care specialty. Green, Debra can be contacted via phone (505) 503-8600.

Contact Information

Primary practice address
1524 Eubank Blvd Ne Ste 6 Albuquerque NM 87112-4160
Phone: (505) 503-8600
Fax: (888) 503-8511
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Physical Medicine & Rehabilitation 208100000X CNP00871 New Mexico
Physician Assistants & Advanced Practice Nursing Providers / Family 363LF0000X R39646 New Mexico

Profile Details

NPI number 1114110558
LBN Legal business name Green, Debra
Credentials MSN, C-FNP
Entity Individual
Sole proprietor 1 Yes
Enumeration date Aug 20th, 2007
Last updated Nov 15th, 2023 - about 2 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 1114110558 NPPES
New Mexico MEDICAID 1114110558
New Mexico MEDICAID 58606823

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