Individual
MRS. EBONYE N GREEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
APN
Contact information
Practice address
4301 W MARKHAM ST, COM DEPARTMENT OF NEUROSURGERY SLOT #506, LITTLE ROCK, AR 72205-7101
(501) 686-5270
Mailing address
6006 WALL ST, BENTON, AR 72019-9098
(314) 249-8539
Taxonomy
Speciality
Code
Description
License number
State
363LA2100X
Acute Care Nurse Practitioner
Primary
A003811
AR
363LC0200X
Critical Care Medicine Nurse Practitioner
A003811
AR
363LG0600X
Gerontology Nurse Practitioner
A003811
AR
Other
Enumeration date
03/01/2013
Last updated
03/01/2013
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