Brady Green
Student in an Organized Health Care Education/Training Program in Boise, ID. Individual provider (NPI-1).
NPI number1720526445
StatusActive
Last updated in NPPESFeb 1, 2017
Details
- NPI
- 1720526445
- Entity type
- Individual (NPI-1)
- Name
- Brady Green
- Sex
- Male
- Sole proprietor
- No
- Enumeration date
- Feb 1, 2017
- Last updated
- Feb 1, 2017
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 |
|---|---|---|---|---|
| 390200000X | Student in an Organized Health Care Education/Training Program | – | ID | Yes |
| 104100000X | Social Worker | – | – |
Practice location
1720 N Westgate DrBoise, ID 83704-7164
Phone 208-334-0800
Mailing address
1720 N Westgate DrBoise, ID 83704-7164
Is something wrong?
This page shows exactly what the provider filed with NPPES. Only the provider (or their surrogate) can change it, by signing in to NPPES. Our page updates within a day of their change. See how to update NPI information.
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All 47 Student in an Organized Health Care Education/Training Program providers in Boise · All 12,265 providers in Boise
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