Individual
AMY GREEN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
4801 AMBASSADOR CAFFERY PKWY, LAFAYETTE, LA 70508-6917
(337) 278-9159
Mailing address
PO BOX 375, CADE, LA 70519-0375
(337) 278-9159
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
RN096295
LA
Other
Enumeration date
11/30/2015
Last updated
11/30/2015
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