Individual
KATINA GREEN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LPN
Contact information
Practice address
312 GLEN PARK, BRIDGETON, NJ 08302-4044
(800) 950-6066
Mailing address
312 GLEN PARK, BRIDGETON, NJ 08302-4044
(800) 950-6066
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
26NP05864600
NJ
Other
Enumeration date
07/18/2007
Last updated
07/18/2007
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