Individual
TINA LUANNE GREEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
FNP-BC
Contact information
Practice address
104 WILLIS PLZ, GAFFNEY, SC 29341-1500
(800) 792-9030
Mailing address
656 SLOAN RD, LYMAN, SC 29365-9509
(864) 580-8000
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
21930
SC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
21930
OFFICE DOES NOT ACCEPT INSURANCE, MEDICARE OR MEDICAID.
SC
Enumeration date
03/14/2019
Last updated
03/14/2019
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