Individual
AMANDA SUZANNE GREEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
FNP
Contact information
Practice address
126 MILESTONE WAY, GREENVILLE, SC 29615-5065
(864) 675-5844
Mailing address
PO BOX 19305, CHARLOTTE, NC 28219-9305
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
5004239
NC
363LF0000X
Family Nurse Practitioner
Primary
5004239
NC
Other
Enumeration date
12/09/2008
Last updated
07/24/2024
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