Individual
STACIE LEIGH GREEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
APRN
Contact information
Practice address
125 S MAIN CROSS ST, LOUISA, KY 41230-1065
(606) 638-0938
Mailing address
301 SUN VALLEY RD, HAZARD, KY 41701-1609
(606) 438-5445
Taxonomy
Speciality
Code
Description
License number
State
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
3014209
KY
Other
Enumeration date
01/22/2020
Last updated
12/20/2024
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