Individual
DIANE GREEN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
RN
Contact information
Practice address
3425 EIGHT STAR WAY, CHESAPEAKE, VA 23323-1181
(757) 412-8773
Mailing address
3425 EIGHT STAR WAY, CHESAPEAKE, VA 23323-1181
(757) 412-8773
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
Primary
0001192113
VA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
7141
NA
—
Enumeration date
01/08/2021
Last updated
01/08/2021
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