Individual
MRS. BARBARA R. GREEN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
7451 103RD ST STE 8, JACKSONVILLE, FL 32210-9300
(904) 683-4968
(904) 902-1202
Mailing address
2675 WINKLER AVE FL 2, FORT MYERS, FL 33901-9342
(877) 856-3774
Taxonomy
Speciality
Code
Description
License number
State
363LG0600X
Gerontology Nurse Practitioner
Primary
11006904
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
OV684
MEDICARE
FL
Enumeration date
05/01/2020
Last updated
02/11/2022
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