Individual
MS. MICHELLE MARIE GREEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
APRN
Contact information
Practice address
1267 N STEAMBOAT DR STE 3, FAYETTEVILLE, AR 72704-7148
(479) 316-6565
(479) 316-0331
Mailing address
1267 N STEAMBOAT DR STE 3, FAYETTEVILLE, AR 72704-7148
(479) 316-6565
(479) 316-0331
Taxonomy
Speciality
Code
Description
License number
State
363LW0102X
Women's Health Nurse Practitioner
Primary
A004383
AR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
208904758
—
AR
Enumeration date
04/13/2015
Last updated
04/28/2021
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