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Individual
MRS. TERESA DESHAWN GREEN
Active
Individual
MRS. TERESA DESHAWN GREEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PHYSICIAN ASSISTANT
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
2662
OK
363A00000X
Physician Assistant
Primary
2962
OK
363A00000X
Physician Assistant
C0003136
MD
363A00000X
Physician Assistant
PA031082
DC
363AM0700X
Medical Physician Assistant
C5-0000491
DE
Other
Enumeration date
02/21/2006
Last updated
03/19/2026
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