Individual
MS. TASHUNDA LATRESE GREEN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
RN
Contact information
Practice address
17830 LARKSPUR LN, HOMEWOOD, IL 60430-1131
(708) 799-6740
Mailing address
17830 LARKSPUR LN, HOMEWOOD, IL 60430-1131
(708) 799-6740
Taxonomy
Speciality
Code
Description
License number
State
163WN0002X
Neonatal Intensive Care Registered Nurse
Primary
041310372
IL
Other
Enumeration date
06/04/2008
Last updated
06/04/2008
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