Individual
CARL GREEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
CRNA
Contact information
Practice address
2321 STOUT ROAD, MENOMONIE, WI 54751-5475
(715) 235-9671
Mailing address
200 1ST ST SW, ROCHESTER, MN 55905-0001
(507) 284-2511
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
12103
WI
367500000X
Certified Registered Nurse Anesthetist
4704199821
MI
Other
Enumeration date
01/18/2012
Last updated
10/05/2022
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