Individual
MARILYN B GREEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NURSE PRACTIONER
Contact information
Practice address
500 CONGRESS ST, QUINCY, MA 02169-0908
(617) 471-0033
(617) 770-4354
Mailing address
500 CONGRESS ST, QUINCY, MA 02169-0908
(617) 471-0033
(617) 770-4354
Taxonomy
Speciality
Code
Description
License number
State
363LA2200X
Adult Health Nurse Practitioner
Primary
114466
MA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0349861
—
MA
Enumeration date
08/02/2005
Last updated
11/10/2009
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