Individual
JAMIE GREEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
FNP-C
Contact information
Practice address
700 E TOWNSHIP LINE RD, HAVERTOWN, PA 19083-5733
(888) 985-2727
Mailing address
60 N 23RD ST APT 2408, PHILADELPHIA, PA 19103-1577
(781) 820-1362
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
SP025925
PA
363LP0200X
Pediatric Nurse Practitioner
SP017214
PA
Other
Enumeration date
02/14/2017
Last updated
07/25/2022
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