Individual
MISS LATOYHA TAMARA GREEN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
FNP-C
Contact information
Practice address
4310 HARD SCRABBLE RD, COLUMBIA, SC 29229-9423
(803) 865-6680
Mailing address
4310 HARD SCRABBLE RD, COLUMBIA, SC 29229-9423
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
21365
SC
Other
Enumeration date
09/10/2017
Last updated
04/29/2019
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