Individual
MELINDA J GREEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CRNA
Contact information
Practice address
1235 E CHEROKEE ST, SPRINGFIELD, MO 65804-2203
(417) 820-2829
Mailing address
1235 E CHEROKEE ST, SPRINGFIELD, MO 65804-2203
(417) 820-2829
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
2011041118
MO
367500000X
Certified Registered Nurse Anesthetist
Primary
2017028741
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
PENDING
—
AR
05
—
PENDING
—
MO
05
—
PENDING
—
OK
Enumeration date
08/03/2017
Last updated
07/21/2022
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