Individual
MRS. THERESA MARIE GREEN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
RN
Contact information
Practice address
9230 NW 12TH PL, GAINESVILLE, FL 32606-5553
(352) 222-2323
Mailing address
9230 NW 12TH PL, GAINESVILLE, FL 32606-5553
(352) 222-2323
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
Primary
1181982
FL
Other
Enumeration date
12/09/2008
Last updated
12/09/2008
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