Individual
KHADIJA GREEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
4065 BISHOP RD, TALLAHASSEE, FL 32305-8317
(850) 408-3099
Mailing address
4065 BISHOP RD, TALLAHASSEE, FL 32305-8317
(850) 408-3099
Taxonomy
Speciality
Code
Description
License number
State
374U00000X
Home Health Aide
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
238419
AHCA
FL
Enumeration date
03/30/2022
Last updated
03/30/2022
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