Individual
MICHELLE D. GREEN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
W4073 COUNTY ROAD C, MONTELLO, WI 53949-8623
(608) 556-4218
Mailing address
W4073 COUNTY ROAD C, MONTELLO, WI 53949-8623
(608) 556-4218
Taxonomy
Speciality
Code
Description
License number
State
251E00000X
Home Health Agency
—
—
253Z00000X
In Home Supportive Care Agency
—
—
311ZA0620X
Adult Care Home Facility
—
—
374U00000X
Home Health Aide
—
—
376G00000X
Nursing Home Administrator
Primary
—
—
376J00000X
Homemaker
—
—
Other
Enumeration date
02/01/2022
Last updated
02/01/2022
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