Individual
CARLA L GREEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
APN
Contact information
Practice address
119 BOONE RIDGE DR, SUITE 201, JOHNSON CITY, TN 37615-4998
(423) 282-1480
(423) 928-1353
Mailing address
119 BOONE RIDGE DR, SUITE 201, JOHNSON CITY, TN 37615-4998
(423) 282-1480
(423) 928-1353
Taxonomy
Speciality
Code
Description
License number
State
163WC0200X
Critical Care Medicine Registered Nurse
RN0000162033
TN
363LF0000X
Family Nurse Practitioner
0024171230
VA
363LF0000X
Family Nurse Practitioner
Primary
18086
TN
Other
Enumeration date
07/02/2013
Last updated
09/11/2015
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