Individual
BIANCA GREEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NP
Contact information
Practice address
5701 BOW POINTE DR, CLARKSTON, MI 48346-3198
(248) 625-2621
(248) 625-2621
Mailing address
2561 ELIZABETH LAKE RD, WATERFORD, MI 48328-3313
(248) 682-3300
(248) 682-0026
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
4704292920
MI
Other
Enumeration date
10/14/2016
Last updated
12/12/2017
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