Individual
MISS EVELET AMANDA GREEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RN
Contact information
Practice address
584 JENNINGS AVE, BRIDGEPORT, BRIDGEPORT, CT 06610-1114
(203) 371-7652
(203) 371-7652
Mailing address
584 JENNINGS AVENUE, BRIDGEPORT, BRIDGEPORT, CT 06610
(203) 371-7652
(203) 371-7652
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
Primary
R45831
CT
Other
Enumeration date
09/28/2009
Last updated
09/28/2009
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