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Individual

JONATHAN GREGORY GREEN

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
FNP

Contact information

Practice address
1701 SKYLYN DR, SPARTANBURG, SC 29307-1096
(864) 393-3909
(864) 302-8433
Mailing address
110 AUDREY DR, SPARTANBURG, SC 29307-1500
(864) 279-3630

Taxonomy

Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
25841
SC

Other

Enumeration date
06/20/2022
Last updated
06/22/2023
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