Individual
JEFFERY MYLES GREEN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
CRNA
Contact information
Practice address
6819 PLUM CREEK DR, AMARILLO, TX 79124-1602
(806) 355-9595
(806) 353-1589
Mailing address
PO BOX 2265, AMARILLO, TX 79105-2265
(806) 355-9595
(806) 353-1589
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
756989
TX
Other
Enumeration date
10/12/2012
Last updated
10/12/2012
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