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Individual
MRS. LAKESHUR ROSHA GREEN
Active
Individual
MRS. LAKESHUR ROSHA GREEN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
FNP
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
658237
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
8L8989
MEDICARE TPAN
—
01
—
8L8990
MEDICARE TPAN
—
01
—
8L8991
MEDICARE TPAN
—
01
—
8L8992
MEDICARE TPAN
—
01
—
8L8993
MEDICARE TPAN
—
01
—
8Y8552
BCBSTX PROVIDER NUMBER
TX
Enumeration date
08/05/2006
Last updated
03/30/2009
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