Individual
MR. ROBERT ALLEN GREEN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
PMHNP-BC
Contact information
Practice address
113 FLAGG PL BLDG B, LAFAYETTE, LA 70508-7025
(337) 247-7282
(337) 279-0776
Mailing address
300 HIGHLAND VIEW DR, YOUNGSVILLE, LA 70592-6080
(318) 834-6298
Taxonomy
Speciality
Code
Description
License number
State
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
221575
LA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
2584294
—
LA
Enumeration date
08/04/2021
Last updated
01/05/2023
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