Individual
MRS. JENNIFER BROOKE GREEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NP
Taxonomy
Speciality
Code
Description
License number
State
363LA2200X
Adult Health Nurse Practitioner
Primary
APRN-NP115738
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
003134778A
—
GA
01
—
01881320
AMERIGROUP
GA
01
—
804217
WELLCARE
GA
01
—
P01156288
RR MEDICARE
GA
Enumeration date
07/31/2009
Last updated
11/04/2025
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