Individual
JULIE LYNN GREEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NP
Contact information
Practice address
950 N MERIDIAN ST, SUITE 500, INDIANAPOLIS, IN 46204-1077
(317) 962-4941
(317) 962-4950
Mailing address
950 N MERIDIAN ST, SUITE 500, INDIANAPOLIS, IN 46204-1077
(317) 962-4941
(317) 962-4950
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
71003884A
IN
363LG0600X
Gerontology Nurse Practitioner
Primary
71003884A
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
201053360
—
IN
Enumeration date
12/15/2011
Last updated
03/27/2012
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