Individual
TERRA E. GREEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
N.P.
Contact information
Practice address
1905 E HUEBBE PKWY, BELOIT CLINIC, BELOIT, WI 53511-1842
(608) 364-2240
(608) 363-7374
Mailing address
1905 E HUEBBE PKWY, BELOIT HEALTH SYSTEM, BELOIT, WI 53511-1842
(608) 364-2200
(608) 363-7395
Taxonomy
Speciality
Code
Description
License number
State
208M00000X
Hospitalist Physician
147601-30
WI
363L00000X
Nurse Practitioner
147601-030
WI
363L00000X
Nurse Practitioner
Primary
5411-33
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1366875908
—
WI
Enumeration date
08/19/2013
Last updated
04/09/2015
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