Individual
JEAN GREEN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
232 CREPE MYRTLE CIR, OCILLA, GA 31774-3348
(229) 325-6068
Mailing address
232 CREPE MYRTLE CIR, OCILLA, GA 31774-3348
(229) 325-6068
Taxonomy
Speciality
Code
Description
License number
State
163WM0705X
Medical-Surgical Registered Nurse
Primary
RN174038
GA
Other
Enumeration date
04/28/2014
Last updated
04/28/2014
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