Individual
ELIZABETH ANNE GREEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NP-C
Contact information
Practice address
10548 W BUSINESS PARK LN, BOISE, ID 83709-6797
(208) 890-7165
Mailing address
10548 W BUSINESS PARK LN, BOISE, ID 83709-6797
(208) 890-7165
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
222008
NC
363LF0000X
Family Nurse Practitioner
Primary
71351
ID
363LF0000X
Family Nurse Practitioner
AP61053942
WA
Other
Enumeration date
06/27/2016
Last updated
03/07/2023
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