Individual
JENNIFER GREEN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
AGACNP
Contact information
Practice address
1799 COUNTY ROAD 2219, CADDO MILLS, TX 75135-8378
(214) 808-0389
Mailing address
1799 COUNTY ROAD 2219, CADDO MILLS, TX 75135-8378
(214) 808-0389
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
1036810
TX
Other
Enumeration date
02/07/2022
Last updated
02/07/2022
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