Data from the NPPES registry. May not reflect recent changes — verify at nppes.cms.hhs.gov.
MARY ALEXIS K GREEN, PA-C
ActivePhysician Assistant · SHREVEPORT, LA
Registration Details
- NPI Number
- 1366436487
- Provider Type
- Individual
- Gender
- Female
- NPI Issued
- Sep 2, 2005 (20.633303206394 yrs)
- Last Updated
- Feb 2, 2026
- License
-
PA.200024 (LA)
Practice Information
- Address
-
1455 E BERT KOUNS INDUSTRIAL LOOP STE 210SHREVEPORT, LA, 711056000Browse LA providers · Browse ZIP 71105
- Phone
- 3187984623
- Fax
- 3187984569
- Primary Specialty
-
Physician Assistant
363A00000X
Other Physician Assistant Providers in SHREVEPORT, LA
| Name | Credential | NPI |
|---|---|---|
| DONNA TERRY | PA-C | 1104823947 |
| KIMBERLY E MEYER | PA-C | 1760475651 |
| KENNETH BETZING | PA-C | 1053304048 |
| MRS. LORI A STACKOW | PAC | 1467449835 |
| MR. MARVIN KEITH RAINWATER | PA | 1457310773 |
| AKANE DANIELS | P.A. | 1700837333 |
Data sourced from the NPPES National Provider Identifier registry. This information is for informational purposes only and is not a substitute for verifying credentials with the appropriate licensing authority. For official verification, use the NPPES NPI Registry or the relevant state medical board.