Individual
CAROL GAYE GREEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
FAMILY NURSE PRACTIT
Contact information
Practice address
2100 N MAIN ST STE 304, CROWN POINT, IN 46307-1877
(574) 546-1900
(574) 546-1999
Mailing address
2100 N MAIN ST STE 304, CROWN POINT, IN 46307-1877
(574) 546-1900
(574) 546-1999
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
71009354A
IN
363LF0000X
Family Nurse Practitioner
1118586
TX
363LF0000X
Family Nurse Practitioner
3013949
KY
363LF0000X
Family Nurse Practitioner
34108
TN
363LF0000X
Family Nurse Practitioner
Primary
71009354A
IN
Other
Enumeration date
04/30/2019
Last updated
12/09/2024
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