Provider Demographics
NPI:1962203638
Name:GREEN, AALIYYAH (LPN)
Entity type:Individual
Prefix:MRS
First Name:AALIYYAH
Middle Name:
Last Name:GREEN
Suffix:
Gender:
Credentials:LPN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:524 SIGNAL HILL DR EXT
Mailing Address - Street 2:
Mailing Address - City:STATESVILLE
Mailing Address - State:NC
Mailing Address - Zip Code:28625-4391
Mailing Address - Country:US
Mailing Address - Phone:704-871-1045
Mailing Address - Fax:
Practice Address - Street 1:524 SIGNAL HILL DR EXT
Practice Address - Street 2:
Practice Address - City:STATESVILLE
Practice Address - State:NC
Practice Address - Zip Code:28625-4391
Practice Address - Country:US
Practice Address - Phone:704-871-1045
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-03-20
Last Update Date:2025-03-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC97701164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse