National Provider Identifier Database

HOLLY GREEN
Nursing Home Administrator

An individual, often licensed by the state, who is responsible for the management of a nursing home.


Contact Information

HOLLY GREEN
3688 SAND CREEK RD
FARMINGTON, MO63640-7350
Phone: 573-756-2917
Fax: 573-756-7347
Website:
Specialty Taxonomy Code
* Nursing Home Administrator 376G00000X

* Indicates primary specialty

NPI Profile & details for HOLLY GREEN

NPI Number 1548644693
Credentials
Entity Individual
Enumeration date 07/17/2015
Last updated 07/17/2015 - About 11 years ago
Sole proprietor1 No
Identifiers
  • MO License #: 043352
  • MO Medicaid: 043352
Hospital affiliation n/a

1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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