Individual
MISS WENDY LYNN GREEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
C.R.N.P
Contact information
Practice address
725 W MARKET ST STE B, ATHENS, AL 35611-2456
(256) 233-5000
(256) 233-5361
Mailing address
725 W MARKET ST STE B, ATHENS, AL 35611-2456
(256) 233-5000
(256) 233-5361
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
1-099815
AL
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
1-099815
AL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
000097370
—
AL
01
—
0004582647
AETNA
AL
01
—
510-97570
BCBS PROVIDER NUMBER
AL
01
—
63-1253914
UNITED HEALTHCARE
AL
01
—
631253914
TRICARE
AL
01
—
631253914
HUMANA PROVIDER #
—
Enumeration date
03/13/2008
Last updated
05/14/2024
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