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Individual

JALEINE TOINETTE GREEN

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
LPN

Contact information

Practice address
900 WILKINSON ST, MANDEVILLE, LA 70448-3533
(985) 624-4450
(985) 624-4461
Mailing address
900 WILKINSON ST, MANDEVILLE, LA 70448-3533
(985) 624-4450
(985) 624-4461

Taxonomy

Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
200760
LA

Other

Enumeration date
09/15/2013
Last updated
09/18/2013
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