Individual
TYLER DOUGLAS GREEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
C.N.P.
Contact information
Practice address
7901 SCHATZ POINTE DR, SUITE A, DAYTON, OH 45459-3856
(937) 438-9841
(937) 438-9851
Mailing address
7901 SCHATZ POINTE DR, SUITE A, DAYTON, OH 45459-3856
(937) 438-9841
(937) 438-9851
Taxonomy
Speciality
Code
Description
License number
State
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
COA.15402-NP
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0097903
—
OH
Enumeration date
12/05/2013
Last updated
01/26/2017
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