Individual
DIANA GREEN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
7530 W CACTUS RD, PEORIA, AZ 85381-5202
(623) 334-4635
Mailing address
7586 W KAREN LEE LN, PEORIA, AZ 85382-4817
Taxonomy
Speciality
Code
Description
License number
State
163WC1500X
Community Health Registered Nurse
Primary
RN201477
AZ
Other
Enumeration date
12/23/2020
Last updated
12/23/2020
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