Individual
MRS. CARRIE LYNN GREEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CRNA
Contact information
Practice address
1100 WILFORD HALL LOOP,BLDG 4554 ATTN: 59 MDW/SGHC, JBSA LACKLAND, TX, TX 78236-9908
(210) 292-5596
Mailing address
PO BOX 821, UTOPIA, TX 78884-0821
(830) 966-2455
(830) 966-2455
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
550629
TX
Other
Enumeration date
02/09/2006
Last updated
07/03/2018
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