Individual
TARA GREEN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
30 E APPLE ST, STE 5254A, DAYTON, OH 45409-2939
(937) 208-4200
(937) 208-4205
Mailing address
30 E APPLE ST, STE 5254A, DAYTON, OH 45409-2939
(937) 208-4200
(937) 208-4205
Taxonomy
Speciality
Code
Description
License number
State
282NC0060X
Critical Access Hospital
RN217893
OH
364S00000X
Clinical Nurse Specialist
Primary
COA.02166-NS
OH
Other
Enumeration date
05/14/2007
Last updated
07/26/2013
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