Individual
MRS. MAXINE GREEN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
RN
Contact information
Practice address
55 BLANK LN, EMPORIA, VA 23847-6339
(804) 722-4299
(804) 722-4283
Mailing address
55 BLANK LN, EMPORIA, VA 23847-6339
(804) 722-4299
(804) 722-4283
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
Primary
0001147008
VA
Other
Enumeration date
07/25/2012
Last updated
07/25/2012
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