Individual
KAWANZA S GREEN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
3022 GUAVA ST, FORT MYERS, FL 33916-1910
(239) 295-1803
(239) 939-7731
Mailing address
3022 GUAVA ST, FORT MYERS, FL 33916-1910
(239) 295-1803
(239) 939-7731
Taxonomy
Speciality
Code
Description
License number
State
376K00000X
Nurse's Aide
Primary
CNA321992
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0000
N/A
—
Enumeration date
10/18/2022
Last updated
10/18/2022
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