Individual
TAMMY S GREEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
ANP
Contact information
Practice address
505 SYCAMORE ST, RISON, AR 71665-7166
(870) 325-6255
(870) 325-6117
Mailing address
PO BOX 509, DERMOTT, AR 71638-0509
(870) 538-5414
(870) 538-5412
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
A003870
AR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
20583958
—
AR
Enumeration date
04/22/2013
Last updated
04/24/2023
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