Shannon Green in Randallstown - Nutrition, Pediatric
Shannon Green - NPI 1164573275
Shannon Green is a Nutrition, Pediatric in Randallstown, Maryland. Shannon Green practices all healthcare services and medical treatments related to Nutrition, Pediatric. The NPI Number for Shannon Green is 1164573275. The last update date is 2012-02-01.
Shannon Green's current location address is 51 Horseman Ct, Randallstown, Maryland. You can contact this provider via phone number 4108776077 and fax number 4108776087. The mailing address for Shannon Green is 51 Horseman Ct, Randallstown, Maryland. To know further, please read the information below!
Provider Profile Detail
| Provider Name | Shannon Green |
|---|---|
| Address | 51 Horseman Ct, Randallstown, Maryland |
| Phone Number | 4108776077 |
| Fax Number | 4108776087 |
| Sole Proprietor | N |
| Credentials | RD CDE CSR |
NPI Number Detail
| NPI Number | 1164573275 |
|---|---|
| Provider Enumeration Date | 2007-01-15 |
| Last Updated Date | 2012-02-01 |
Provider Mailing Address Detail
| Address | 51 Horseman Ct |
|---|---|
| City | Randallstown |
| State | Maryland (MD) |
| Post Code | 211334065 |
| Phone Number | 4108776077 |
| Fax Number | 4108776087 |
Provider's Primary Taxonomy Detail
| Speciality | Nutrition, Pediatric |
|---|---|
| Taxonomy | 133Vn1004X |
| Licence No | D01526 |
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Definition: An individual who is a Board Certified Specialist in Pediatric Nutrition and applies evidence-based nutrition knowledge in providing medical nutrition therapy for pediatric patients. Specialists work directly with healthy and/or ill children (newborn |
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Provider's Other Legacy Identifiers
| Identifier | Identifier Type | Identifier State | Identifier Issuer |
|---|---|---|---|
| 61553701 | MD | CAREFIRST BLUE CROSS BLUE SHIE | |
| G3980001 | MD | GROUP HOSPITALIZATION AND MEDI | |
| 3072804 | MD | AETNA, HMO | |
| 400754900 | MD | -- | |
| 7455454 | MD | AETNA,NON HMO | |
| 2122754 | UNITEDHEALTHCARE |
Post Comment/ Review Below
What is the unique provider identifier assigned to Shannon Green?
The Shannon Green has been issued the NPI (National Provider Identifier) 1164573275 by the Centers for Medicare & Medicaid Services (CMS). This 10-digit code is a unique identification number for healthcare providers.
Where is the Shannon Green located?
The Shannon Green is located at 51 Horseman Ct, Randallstown, MD 211334065.
What is Shannon Green's area of expertise and its corresponding taxonomy classification?
The Shannon Green's field of specialization is Nutrition, Pediatric, and it falls under the taxonomy code 133Vn1004X, which categorizes healthcare providers based on their areas of practice.
On what date did the Centers for Medicare & Medicaid Services assign the 1164573275 to Shannon Green?
The Centers for Medicare & Medicaid Services assigned the 1164573275 to Shannon Green on 2007-01-15.
As of what date were the details related to Shannon Green most recently updated or revised?
The information pertaining to Shannon Green, including its address, specialty, and other relevant details, was last updated or revised on 2012-02-01.