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Individual

TAYLOR ANN GREEN

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F

Contact information

Practice address
1509 STATE STREET, LA PORTE, IN 46350
(219) 324-3431
Mailing address
14130 HERITAGE WAY, CEDAR LAKE, IN 46303-7297
(219) 798-1680

Taxonomy

Speciality
Code
Description
License number
State
363LP0200X
Pediatric Nurse Practitioner
Primary
71014069A
IN

Other

Enumeration date
08/14/2023
Last updated
08/14/2023
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