Individual
KASEY CORY GREEN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
2900 S TELEPHONE RD, SUITE 250, MOORE, OK 73160-2968
(405) 237-7507
Mailing address
2900 S TELEPHONE RD, SUITE 250, MOORE, OK 73160-2968
(405) 237-7507
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
87123
OK
363L00000X
Nurse Practitioner
Primary
R0087123
OK
363LF0000X
Family Nurse Practitioner
87123
OK
Other
Enumeration date
09/23/2014
Last updated
05/15/2025
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