Individual
NICOLE D GREEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NP
Contact information
Practice address
13100 RIVER RD, DESTREHAN, LA 70047-5219
(985) 764-7669
Mailing address
1514 JEFFERSON HWY, NEW ORLEANS, LA 70121-2429
(504) 842-4000
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
F0611104
LA
Other
Enumeration date
08/05/2011
Last updated
11/25/2024
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