| Doctor Name: | JULIA GREEN |
| NPI Number: | 1114391034 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | NP |
| License Number: | RN262790 |
| Business Practice Address: | 1575 Blue Hill Ave Mattapan, MA - 021262122 |
| Business Phone Number: | 6172960061 |
| Business Fax Number: | 6172965408 |
| Mailing Address: | 1575 Blue Hill Ave, MATTAPAN |
| State: | MA |
| Postal Code: | 021262122 |
| Phone Number: | 6172960061 |
| Fax Number: | 6172965408 |
| NPI Enumeration Date: | 11/16/2015 |
| NPI Last Update Date: | 12/15/2015 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 363LA2200X |
| License Number: | RN262790 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | MA |
| Taxonomy Type: | Physician Assistants & Advanced Practice Nursing Providers |
| Taxonomy Classification: | Nurse Practitioner |
| Taxonomy Specialization: | Adult Health |
| Taxonomy Definition: | |