Individual
CASSANDRA GREEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
FNP
Contact information
Practice address
2705 N LEBANON ST STE 300, LEBANON, IN 46052-8622
(765) 485-8649
(765) 485-8650
Mailing address
2605 N LEBANON ST, LEBANON, IN 46052-1476
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
71009464A
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
300032257
—
IN
Enumeration date
10/18/2019
Last updated
02/06/2024
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