Individual
REBECCA J GREEN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
APRN
Contact information
Practice address
803 MEYERS BAKER RD STE 200, LONDON, KY 40741-3040
(606) 878-3240
(606) 878-3245
Mailing address
515 MEMORIAL DR, SUITE 3, MANCHESTER, KY 40962-9157
(606) 599-0169
(606) 599-0297
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
3010388
KY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
3010388
KENTUCY LICENSE
KY
Enumeration date
07/11/2016
Last updated
03/31/2022
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