Individual
JORDAN GREEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
CRNA
Contact information
Practice address
800 N FANT ST, ANDERSON, SC 29621-5708
(864) 316-8710
Mailing address
200 S MEMMINGER ST, GREENVILLE, SC 29601-4019
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
30524
SC
Other
Enumeration date
08/08/2025
Last updated
08/08/2025
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