Individual
MS. CHARLOTTE RENAE GREEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PMHNP-BC
Contact information
Practice address
4579 S EASON BLVD, TUPELO, MS 38801-6539
(662) 377-7590
(662) 377-7595
Mailing address
4579 S EASON BLVD, TUPELO, MS 38801-6539
(662) 377-7590
(662) 377-7595
Taxonomy
Speciality
Code
Description
License number
State
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
R853585
MS
Other
Enumeration date
06/07/2010
Last updated
06/07/2010
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