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

Kevin Green

Individual provider Family Nurse Practitioner · NPI 1508638073

Kevin Green is a Nurse Practitioner in Troy, Michigan. Qualified in 2023, 3 years ago. Practices with Park Family Health Care PC, a 20-clinician group, accepts Medicare assignment and offers telehealth. Licensed in Michigan.

Years since qualifying
3
Licensed in
MI
In the registry since
2023
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Practice location Address checks out

671 E Big Beaver Rd Ste 111
Troy, MI 48083-1421
Phone: (248) 244-8545
Fax: (248) 244-8582
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Family Nurse Practitioner (primary) Taxonomy 363LF0000X · Licence 4704366840 (MI)

Record details

NPI number1508638073
Entity typeIndividual (Type 1)
GenderMale
Sole proprietorNo
NPI enumeratedOctober 26, 2023
Last updated in NPPESJanuary 7, 2025
Certification dateJanuary 7, 2025

Medicare enrollment

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

Medicare specialtyNURSE PRACTITIONER
Medical schoolOTHER
Graduated 2023 (3 years in practice)
Group practice Park Family Health Care Pc — 20 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount
TelehealthOffers telehealth services

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