Individual
KEAUNA TYSHEMA GREEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
3610 GREENMOUNT AVE, BALTIMORE, MD 21218-2510
(443) 226-1566
Mailing address
7029 ALDEN RD, PIKESVILLE, MD 21208-6038
(443) 622-7832
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
Primary
R237797
MD
Other
Enumeration date
02/17/2023
Last updated
02/17/2023
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