Individual
MRS. JODY L GREEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RN
Contact information
Practice address
48 W 1500 N, NEPHI, UT 84648
(435) 623-3000
(435) 623-3123
Mailing address
48 W 1500 N, PO BOX 412, NEPHI, UT 84648
(435) 623-3000
(435) 623-3123
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
Primary
4877049-3102
UT
163WD0400X
Diabetes Educator Registered Nurse
004749
UT
Other
Enumeration date
02/11/2010
Last updated
01/24/2011
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