Individual
CAROL GREEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
3455 S. CRAIG RD STE B, LAS VEGAS, NV 89032
(702) 776-7772
Mailing address
1835 GENTLE DAWN AVE, NORTH LAS VEGAS, NV 89084-2057
(702) 419-3416
Taxonomy
Speciality
Code
Description
License number
State
172V00000X
Community Health Worker
Primary
—
NV
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1811325095
—
NV
Enumeration date
12/26/2013
Last updated
12/26/2013
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