Individual
DR. AMANDA B GREENE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
DNP, NP-C
Contact information
Practice address
625 S PEAR ORCHARD RD, STE B, RIDGELAND, MS 39157-4836
(601) 499-0282
(601) 499-0347
Mailing address
625 S PEAR ORCHARD RD, STE B, RIDGELAND, MS 39157-4836
(601) 499-0282
(601) 499-0347
Taxonomy
Speciality
Code
Description
License number
State
2084N0400X
Neurology Physician
870536
MS
363LA2200X
Adult Health Nurse Practitioner
Primary
870536
MS
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
08800015
—
MS
01
—
P01627831
RAILROAD MEDICARE PTAN
MS
Enumeration date
09/17/2013
Last updated
09/16/2020
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