Individual
AMANDA L GREENE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
3200 E RACINE ST, JANESVILLE, WI 53546-2343
(608) 371-8000
Mailing address
3200 E RACINE ST, JANESVILLE, WI 53546-2343
(608) 371-8000
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
7872-33
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1235656976
—
WI
Enumeration date
08/24/2017
Last updated
04/27/2022
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