Individual
ALECIA GREEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
FNP-BC
Contact information
Practice address
801 MACARTHUR BLVD STE 404, MUNSTER, IN 46321-2919
(219) 836-2995
(219) 836-4075
Mailing address
8558 BROADWAY, MERRILLVILLE, IN 46410-7032
(219) 392-7084
(219) 703-6854
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
28240743A
IN
363LF0000X
Family Nurse Practitioner
Primary
71013726A
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
300073309
—
IN
Enumeration date
02/14/2023
Last updated
04/12/2023
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