Individual
HOLLY JANE GREEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NP
Contact information
Practice address
6401 AUBURN DR, VIRGINIA BEACH, VA 23464-3601
(757) 961-3055
Mailing address
6401 AUBURN DR, VIRGINIA BEACH, VA 23464-3601
(757) 961-3055
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
3464314405
UT
363LF0000X
Family Nurse Practitioner
Primary
0024172990
VA
363LF0000X
Family Nurse Practitioner
3464314405
UT
Other
Enumeration date
04/15/2008
Last updated
12/15/2015
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