Individual
LISA MARIE HANNAH GREEN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
RN
Contact information
Practice address
3152 SUMMERTON CT, POWDER SPRINGS, GA 30127-7033
(678) 598-0445
Mailing address
1750 POWDER SPRINGS RD SW STE 190-269, MARIETTA, GA 30064-4850
(678) 598-0445
Taxonomy
Speciality
Code
Description
License number
State
163WA2000X
Administrator Registered Nurse
Primary
RN169214
GA
Other
Enumeration date
05/28/2021
Last updated
05/28/2021
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