Brandi Marie Green, R.N.
Registered Nurse, Emergency in Libertyville, IL. Individual provider (NPI-1).
NPI number1700936713
StatusActive
Last updated in NPPESJul 8, 2007
Details
- NPI
- 1700936713
- Entity type
- Individual (NPI-1)
- Name
- Mrs. Brandi Marie Green
- Credential
- R.N.
- Sex
- Female
- Sole proprietor
- No
- Enumeration date
- Jan 11, 2007
- Last updated
- Jul 8, 2007
Medicare and OIG
- Medicare enrolled (PECOS)
- Not in the Medicare enrollment file
- Can order and refer
- Not on the CMS order and referring list
- OIG exclusion list
- This NPI is not listed
CMS and OIG files of November 2026. PECOS lookup · OIG exclusion check
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 163WE0003X | Registered Nurse, Emergency | 041-343332 | IL | Yes |
| 163WE0003X | Registered Nurse, Emergency | RN00151370 | WA |
Practice location
801 S Milwaukee AveLibertyville, IL 60048-3204
Phone 847-990-5300
Mailing address
1880 Intrepid St Apt BGreat Lakes, IL 60088-1256
Phone 847-473-9165
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