Individual
MRS. JAIME M GREEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
APRN/CNP
Contact information
Practice address
632 W GIBSON RD, WOODLAND, CA 95695-5169
(530) 668-2605
Mailing address
632 W GIBSON RD, WOODLAND, CA 95695-5169
(530) 668-2605
Taxonomy
Speciality
Code
Description
License number
State
363LP2300X
Primary Care Nurse Practitioner
Primary
NP20468
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
20468
FURNISHING LICENSE
CA
01
—
552312
RN LICENSE
CA
01
—
NP20468
NURSE PRACTITIONER
CA
Enumeration date
05/26/2006
Last updated
03/06/2012
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