Individual
PHILLIP EDWARD GREEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
800 E 28TH ST, MINNEAPOLIS, MN 55407-3723
(612) 863-4000
Mailing address
2040 SHENANDOAH CT UNIT C, PLYMOUTH, MN 55447-6421
(320) 237-6548
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
2126
MN
Other
Enumeration date
09/01/2017
Last updated
11/03/2017
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