Individual
ZACIA GREEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NP
Contact information
Practice address
1311 W 96TH ST STE 110, INDIANAPOLIS, IN 46260-1172
(317) 876-3699
Mailing address
2120 CANVASBACK DR, INDIANAPOLIS, IN 46234-8807
(317) 332-2918
Taxonomy
Speciality
Code
Description
License number
State
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
71012739A
IN
Other
Enumeration date
08/15/2022
Last updated
08/15/2022
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