Individual
KELLY GREEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1061 HARMON AVE, WINN ARMY COMMUNITY HOSPITAL, FORT STEWART, GA 31314-5641
(912) 435-6512
Mailing address
909 BRADWELL ST, HINESVILLE, GA 31313-2204
Taxonomy
Speciality
Code
Description
License number
State
163WE0003X
Emergency Registered Nurse
Primary
RN 178967
GA
Other
Enumeration date
08/18/2014
Last updated
08/20/2014
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