Individual
STACY JO GREEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CRNP
Contact information
Practice address
120 WASHINGTON TOWNE BLVD N, EDINBORO, PA 16412-1254
(814) 877-7500
(814) 877-7510
Mailing address
120 WASHINGTON TOWNE BLVD N, EDINBORO, PA 16412-1254
(814) 877-7500
(814) 877-7510
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
SP010692
PA
Other
Enumeration date
02/08/2010
Last updated
08/10/2021
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