Individual
BROOKE ELISE GREEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RN
Contact information
Practice address
3965 SWEETWATER PKWY, ELLENWOOD, GA 30294-1575
(404) 956-8845
Mailing address
3965 SWEETWATER PKWY, ELLENWOOD, GA 30294-1575
(404) 956-8845
Taxonomy
Speciality
Code
Description
License number
State
363LG0600X
Gerontology Nurse Practitioner
Primary
APRN322122
GA
390200000X
Student in an Organized Health Care Education/Training Program
Primary
RN322122
GA
Other
Enumeration date
09/03/2024
Last updated
06/12/2026
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