Individual
SAMANTHA GREEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
DNP, AGACNP-BC
Contact information
Practice address
11800 E 12 MILE RD, WARREN, MI 48093-3472
(586) 573-5000
Mailing address
11800 E 12 MILE RD, WARREN, MI 48093-3472
Taxonomy
Speciality
Code
Description
License number
State
363LA2100X
Acute Care Nurse Practitioner
Primary
4704307160
MI
363LC0200X
Critical Care Medicine Nurse Practitioner
4704307160
MI
Other
Enumeration date
11/24/2021
Last updated
06/13/2023
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