Individual
JANICE LYNN GREEN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
7471 N FRESNO ST, FRESNO, CA 93720-2457
(559) 436-4500
(559) 261-1526
Mailing address
7471 N FRESNO ST, FRESNO, CA 93720-2457
(559) 436-4500
(559) 261-1526
Taxonomy
Speciality
Code
Description
License number
State
363LP0200X
Pediatric Nurse Practitioner
Primary
602733
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
GR0043790
MEDICAL ID FOR BAZ ALLERGY, ASTHM & SINUS CENTER
CA
01
—
ZZZ21572Z
GROUP PTAN FOR BAZ ALLERGY,ASTHMA & SINUS CENTER
CA
Enumeration date
08/05/2010
Last updated
08/15/2011
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