Individual
MS. JENIFER LYN GREEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CNP
Contact information
Practice address
1221 SIXTH ST STE 300, TRAVERSE CITY, MI 49684-2360
(231) 392-0640
Mailing address
1221 SIXTH ST STE 300, TRAVERSE CITY, MI 49684-2360
Taxonomy
Speciality
Code
Description
License number
State
363LA2200X
Adult Health Nurse Practitioner
Primary
4704299051
MI
363LA2200X
Adult Health Nurse Practitioner
A0307202
IL
Other
Enumeration date
05/08/2007
Last updated
12/18/2020
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