Individual
MS. FAQUETA KENISHA GREEN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
APRN, PMHNP-BC
Contact information
Practice address
633 STEPHENSON AVE, SAVANNAH, GA 31405-5970
(912) 224-3641
Mailing address
134 ROSEBERRY CIR, PORT WENTWORTH, GA 31407-5613
(912) 224-3641
Taxonomy
Speciality
Code
Description
License number
State
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
209710
GA
Other
Enumeration date
02/04/2020
Last updated
02/04/2020
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