Individual
MR. DANIEL NICK GREEN
Active
Sole proprietor
Provider details
NPI number
Gender
Man
Credential
RN
Contact information
Practice address
9282 LYTHAM DR, SHREVEPORT, LA 71129-4834
(318) 688-5112
Mailing address
9282 LYTHAM DR, SHREVEPORT, LA 71129-4834
(318) 688-5112
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
Primary
71606
LA
Other
Enumeration date
02/15/2006
Last updated
07/08/2007
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