Individual
MITSA Y GREENE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CRNA
Contact information
Practice address
7051 SOUTHPOINT PKWY S, #100, JACKSONVILLE, FL 32216-8713
(904) 854-4854
Mailing address
12925 LITTLETON BEND RD, JACKSONVILLE, FL 32224-7904
(904) 613-1959
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
ARNP3405122
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0007362-00
—
FL
05
—
625003589A
—
GA
05
—
625003589B
—
GA
Enumeration date
02/10/2009
Last updated
05/23/2013
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