Individual
EMILY GREEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
WHNP-BC
Contact information
Practice address
2120 BERT KOUNS INDUSTRIAL LOOP STE A, SHREVEPORT, LA 71118-3351
(318) 688-3350
Mailing address
1421 W MARIA ST, BOSSIER CITY, LA 71112-3714
(318) 455-7708
Taxonomy
Speciality
Code
Description
License number
State
363LW0102X
Women's Health Nurse Practitioner
Primary
207719
LA
Other
Enumeration date
08/05/2019
Last updated
08/05/2019
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