Individual
CARLA GREEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RN
Contact information
Practice address
5500 E KELLOGG DR, WICHITA, KS 67218-1607
(316) 685-2221
Mailing address
5500 E KELLOGG DR, WICHITA, KS 67218-1607
(940) 395-1472
Taxonomy
Speciality
Code
Description
License number
State
163WG0000X
General Practice Registered Nurse
Primary
13-91978-081
KS
163WG0000X
General Practice Registered Nurse
755624
KS
Other
Enumeration date
01/18/2023
Last updated
02/14/2023
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