National Provider Identifier
Chanhom L Green, REGISTERED NURSE
Chanhom L Green, REGISTERED NURSE is listed in the NPPES registry with a primary specialty of School Registered Nurse in Ithaca, NY and a listed phone number of (607) 257-1555.
Profile Overview
- NPI
- 1124799176
- Provider Type
- Individual
- Primary Specialty
- School Registered Nurse
- Enumeration Date
- September 21, 2021
- Last Updated
- September 21, 2021
Practice Location
- 555 Warren RD
- Ithaca, NY 14850-1862
Phone: (607) 257-1555
Specialties
- School Registered Nurse (163WS0200X)
Full Record
- NPI
- 1124799176
- Entity Type
- Individual
- Last Name
- Green
- First Name
- Chanhom
- Middle Name
- L
- Name Prefix
- Mrs.
- Credential
- REGISTERED NURSE
- Mailing Street Address
- 555 Warren RD
- Mailing City
- Ithaca
- Mailing State
- NY
- Mailing ZIP Code
- 14850-1862
- Mailing Country
- US
- Mailing Phone
- (607) 257-1555
- Mailing Fax
- (607) 257-1555
- Practice Street Address
- 555 Warren RD
- Practice City
- Ithaca
- Practice State
- NY
- Practice ZIP Code
- 14850-1862
- Practice Country
- US
- Practice Phone
- (607) 257-1555
- Practice Fax
- (607) 697-8220
- Enumeration Date
- September 21, 2021
- Last Updated
- September 21, 2021
- Sex
- Female
- Sole Proprietor
- Yes
- Certification Date
- September 14, 2021
- updated_by_file
- npidata_pfile_20050523-20260308.csv
- Taxonomies
- School Registered Nurse (163WS0200X)