Individual
JOHN GREEN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
RNFA
Contact information
Practice address
6724 CASTLE CREEK DR, FORT WORTH, TX 76132-3708
(817) 294-2087
(817) 656-3392
Mailing address
6724 CASTLE CREEK DR, FORT WORTH, TX 76132-3708
(817) 294-2087
(817) 656-3392
Taxonomy
Speciality
Code
Description
License number
State
163WR0006X
Registered Nurse First Assistant
Primary
572015
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
572015
RN LICENSE
TX
Enumeration date
09/21/2007
Last updated
09/21/2007
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