Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
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Kwaisi-Ann Green

Individual provider Psychiatric/Mental Health Nurse Practitioner · NPI 1164233136

Kwaisi-Ann Green is a Nurse Practitioner in Philadelphia, Pennsylvania. Qualified in 2024, 2 years ago. Practices as a sole proprietor. Licensed in Pennsylvania.

Years since qualifying
2
Licensed in
PA
In the registry since
2025
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Practice location Address checks out

6823 Oakley St
Philadelphia, PA 19111-3914
Phone: (215) 758-5248
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Psychiatric/Mental Health Nurse Practitioner (primary) Taxonomy 363LP0808X · Licence SP031289 (PA)

Record details

NPI number1164233136
Entity typeIndividual (Type 1)
GenderFemale
Sole proprietorYes
NPI enumeratedJanuary 17, 2025
Last updated in NPPESJanuary 17, 2025
Certification dateJanuary 17, 2025

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyNURSE PRACTITIONER
Medical schoolOTHER
Graduated 2024 (2 years in practice)
Accepts Medicare assignment Not indicated

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