| Doctor Name: | AMBER STAR GREEN |
| NPI Number: | 1205987047 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | NP |
| License Number: | 7443 |
| Business Practice Address: | 3116 S Legacy Park Blvd Fort Mill, SC - 297077827 |
| Business Phone Number: | 3476333342 |
| Business Fax Number: | |
| Mailing Address: | 3116 S Legacy Park Blvd, FORT MILL |
| State: | SC |
| Postal Code: | 297077827 |
| Phone Number: | 3476333342 |
| Fax Number: | |
| NPI Enumeration Date: | 01/16/2007 |
| NPI Last Update Date: | 05/02/2016 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 363LF0000X |
| License Number: | 7443 |
| Healthcare Provider Taxonomy: (Secondary) | N |
| State: | TN |
| Taxonomy Type: | Physician Assistants & Advanced Practice Nursing Providers |
| Taxonomy Classification: | Nurse Practitioner |
| Taxonomy Specialization: | Family |
| Taxonomy Definition: | |