Individual
BARBARA GREEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NURSE PRACTITIONER
Contact information
Practice address
514C E WOODROW WILSON AVE, JACKSON, MS 39216-4538
(601) 981-7198
(601) 981-6616
Mailing address
514C E WOODROW WILSON AVE, P.O. BOX 4610, JACKSON, MS 39216-4538
(601) 981-7198
(601) 981-6616
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
F0807357
MS
Other
Enumeration date
10/30/2007
Last updated
10/30/2007
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