Individual
JENNIFER NICOLE GREEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NP-C
Contact information
Practice address
2421 COUNTY ROAD 16, LOUIN, MS 39338-3230
(931) 384-8212
Mailing address
500 W 190TH ST STE 400, GARDENA, CA 90248-4290
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
22027
TN
363LF0000X
Family Nurse Practitioner
Primary
903916
MS
Other
Enumeration date
10/21/2016
Last updated
01/04/2023
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