Provider Demographics
NPI:1225860711
Name:GREEN LOTUS HEALTH & WELLNESS PLLC
Entity type:Organization
Organization Name:GREEN LOTUS HEALTH & WELLNESS PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:MARLENE
Authorized Official - Middle Name:ANGELA
Authorized Official - Last Name:BROWN
Authorized Official - Suffix:
Authorized Official - Credentials:PMHNP-BC, APRN-CNP
Authorized Official - Phone:501-613-7863
Mailing Address - Street 1:2101 S BLACKHAWK ST STE 240
Mailing Address - Street 2:
Mailing Address - City:AURORA
Mailing Address - State:CO
Mailing Address - Zip Code:80014-1475
Mailing Address - Country:US
Mailing Address - Phone:501-613-7863
Mailing Address - Fax:580-297-9105
Practice Address - Street 1:2101 S BLACKHAWK ST STE 240
Practice Address - Street 2:
Practice Address - City:AURORA
Practice Address - State:CO
Practice Address - Zip Code:80014-1475
Practice Address - Country:US
Practice Address - Phone:501-613-7863
Practice Address - Fax:580-297-9105
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-08-14
Last Update Date:2025-01-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental HealthGroup - Multi-Specialty