Individual
AMANDA DONELLE GREEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NP
Contact information
Practice address
4330 MEDICAL DR STE 500, SAN ANTONIO, TX 78229-3318
(210) 732-3668
(210) 732-3338
Mailing address
4330 MEDICAL DR STE 500, SAN ANTONIO, TX 78229-3318
(210) 732-3668
(210) 732-3338
Taxonomy
Speciality
Code
Description
License number
State
363LA2100X
Acute Care Nurse Practitioner
Primary
AP121232
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
723578-RN
PROFESSIONAL LICENSE
TX
Enumeration date
05/11/2012
Last updated
10/08/2021
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