Individual
INDIA GREEN BYNUM
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CRNA
Contact information
Practice address
2485 HEMBY LN, SUITE A, GREENVILLE, NC 27834-3701
(252) 752-2140
(888) 787-2249
Mailing address
2485 HEMBY LN, SUITE A, GREENVILLE, NC 27834-3701
(252) 752-2140
(888) 787-2249
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
223297
NC
367500000X
Certified Registered Nurse Anesthetist
Primary
92654
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1538503941
TRICARE
NC
05
—
1538503941
—
NC
Enumeration date
04/29/2013
Last updated
11/12/2015
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