Provider / Organization | NPI | Date Certified |
---|---|---|
JACLYNN S GREEN | 1518501394 | 2021-01-17 |
Jaclynn S Green [F] graduated in 2019 and primarily specializes in Nurse Practitioner.
Jaclynn S Green is registered with the National Plan and Provider Enumeration System and has been issued an National Provider Identifier (NPI) of 1518501394. Registration indicates Jaclynn S Green is a provider of access to adult/geriatric primary care providers services with a specialization in Physician Assistants & Advanced Practice Nursing Providers, Nurse Practitioner Access to Pediatric Primary Care Providers (Physician Assistants & Advanced Practice Nursing Providers, Nurse Practitioner) (Physician Assistants & Advanced Practice Nursing Providers, Nurse Practitioner) (Nurse Practitioner: Family, ) (All Other Specialties & Provider Types, ) (Nurse Practitioner Family, Physician Assistants & Advanced Practice Nursing Providers) (Nurse Practitioner, )
PECOS ID | 7810318094 |
Registration | PART-B:Y DME:Y HHA:Y PMD:Y |
Entity Type | Individual |
Provider Name | Jaclynn S Green FNP |
Practice Office Address | 800 MEADOWS RD BOCA RATON, FL US |
Practice Office Telephone | 5619554500 |
Mailing Address | 2583 NW TIMBERCREEK CIR BOCA RATON, FL 334314026 US |
Business Telephone | 5615040536 |
Code | Practice | License No State |
---|---|---|
363LF0000X PRIMARY | Access to Adult/Geriatric Primary Care Providers Physician Assistants & Advanced Practice Nursing Providers Nurse PractitionerAccess to Pediatric Primary Care Providers Physician Assistants & Advanced Practice Nursing Providers Nurse Practitioner Physician Assistants & Advanced Practice Nursing Providers Nurse Practitioner Nurse Practitioner: Family All Other Specialties & Provider Types Nurse Practitioner Family Physician Assistants & Advanced Practice Nursing Providers Nurse Practitioner | 5012494
NC |