Individual
MR. CHARLES WESLEY GREEN III
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
FNP-BC, FNP-C
Contact information
Practice address
4445 COLBATH AVE APT 107, SHERMAN OAKS, CA 91423-3523
(859) 620-4762
Mailing address
4445 COLBATH AVE APT 107, SHERMAN OAKS, CA 91423-3523
(859) 620-4762
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
784730
CA
Other
Enumeration date
07/22/2024
Last updated
07/22/2024
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