Individual
MRS. KIMBERLY MARIE GREEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1132 LONG MDW, SALADO, TX 76571-5453
(254) 289-1724
Mailing address
1132 LONG MDW, SALADO, TX 76571-5453
(254) 289-1724
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
Primary
788531
TX
Other
Enumeration date
06/04/2019
Last updated
06/04/2019
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