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Individual

BETHANY GREEN

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
NP

Contact information

Practice address
3443 DICKERSON PIKE, STE. 680, NASHVILLE, TN 37207
(615) 865-3322
(615) 467-6692
Mailing address
3443 DICKERSON PIKE, STE. 680, NASHVILLE, TN 37207-2519
(615) 865-3322
(615) 467-6692

Taxonomy

Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
21095
TN

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
6063696
BLUE CROSS OF TN
TN
05
7100467920
KY
05
Q020593
TN
Enumeration date
03/22/2016
Last updated
06/21/2018
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