Individual provider · Type 1 NPI

Kourtney Green, FNP

Nurse Practitioner · Fort Wayne, IN

NPI number 1972910602 Active

Practice location

3512 Stellhorn Rd
Fort Wayne, IN 46815-4631

Fax (260) 483-9196

Mailing address

PO Box 392552
Pittsburgh, PA 15251-9500

Specialties and licenses

TaxonomyCodeLicense
Nurse Practitioner 363L00000X2013011851 (MO)
Nurse Practitioner Primary 363L00000X71005675A (IN)

Nurse Practitioner: (1) A registered nurse provider with a graduate degree in nursing prepared for advanced practice involving independent and interdependent decision making and direct accountability for clinical judgment across the health care continuum or in a certified specialty. (2) A registered nurse who has completed additional training beyond basic nursing education and who provides primary health care services in accordance wit…

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About NPI 1972910602

Kourtney Green, FNP's National Provider Identifier is 1972910602, issued on Jul 15, 2014. The primary taxonomy on file is Nurse Practitioner (363L00000X), and the practice location is in Fort Wayne, IN. The record was last updated on Jul 16, 2020.