JAUCLYN RENEE GREEN (NP) – Nurse Practitioner, NPI 1063068062

Nurse Practitioner

JAUCLYN RENEE GREEN (NP) is a healthcare provider. based in Fairmont, Minnesota. specializing in Nurse Practitioner. They hold the professional credentials NP. They hold a License No. 25205 (TN). The NPI Number for JAUCLYN RENEE GREEN (NP) is 1063068062

Main info

Female

8 Years Of Experience

Accepts Medicare Assignment

Name

JAUCLYN RENEE GREEN (NP)

NPI

1063068062

Phone

(507) 238-8100

Address

800 MEDICAL CENTER DR

Enumeration Date

15 August 2019

Last Update Date

11 November 2020

Doctor Profile

Medical School Name

OTHER

Secondary Phone

5072388555

Graduation Year

2018 (8 years ago)

PAC ID

9537498944

Group Practice PAC ID

4981694981

Professional Enrollment ID

I20190911000101

Data current as of

19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology

Experience45

Completeness75

Years active:6State licenses:2Digital endpointsOther names

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Provider Addresses for JAUCLYN RENEE GREEN (NP)

The Drive, Norwood, Fairmont, Marion County, West Virginia, 26554, United States
FAIRMONT, MN 560314575
Phone: (507) 238-8100
Type: Location
2884 SIMMONS RD
DRUMMONDS, TN 380234958
Phone: (901) 230-0489
Type: Mailing

NPPES updates history

No NPPES updates recorded for this provider.

Prescription Activity

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Open Payments (CMS)

No Open Payments data available for this provider.

This can happen when there are no reportable CMS Open Payments records.

Medicare Enrollment & Revalidation

Source: CMS public data · Not endorsed by CMS ·

Educational use only—not medical, billing, or legal advice.

No Medicare enrollment or revalidation data available for this provider in our database.

Prepare CMS-855 application → · Look up this NPI in PECOS → · Verify on CMS PECOS

Medicare Utilization (FFS)

Source: CMS public data · Not endorsed by CMS · Beneficiary counts under 11 are suppressed in source data ·

Educational use only—not medical, billing, or legal advice.

No Medicare fee-for-service utilization data available for this provider in our database.

Insurance plans in this area (ZIP 56031)

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Group practice members

Group practice members are other physicians who share the same Group Practice PAC ID with this doctor. When doctors form a group practice and register in PECOS as a single entity, they receive a shared identification number. This table lists all providers in the same group practice.

PAC ID: 4981694981View full group profile

Name	Specialty	State
TODD DONALDSON MILLER (M.D.)	-	MN
ANNE SHEPPARD (RD)	-	MN
DR. PETER B RYAN REICHERT (M.D.)	Diagnostic Radiology	MN
PAUL M MCKIE (MD)	Advanced Heart Failure And Transplant Cardiology, Cardiovascular Disease (Cardiology)	MN
ROBERT FRIESE (OD)	O P T O M E T R Y	MN
JULIE M. ROLSTAD (RN, ANP-BC)	-	MO
JEFFERY GREEN (M.D.)	Family Practice	MN
STEPHEN OTTO BERTHELSEN (MD)	-	MN
GRACE LIN (M.D.)	Cardiovascular Disease (Cardiology)	MN
DR. PETER ALEXANDER NOSEWORTHY (M.D.)	Cardiovascular Disease (Cardiology)	WI