Individual
LYNNETTE GREEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
3101 JEFFERSON DAVIS HWY, ALEXANDRIA, VA 22305-3042
(703) 706-3852
Mailing address
3101 JEFFERSON DAVIS HWY, ALEXANDRIA, VA 22305-3042
(703) 706-3852
Taxonomy
Speciality
Code
Description
License number
State
183700000X
Pharmacy Technician
Primary
0230021130
VA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0230021130
PHARMACY TECHNICIAN LICENSE
VA
Enumeration date
02/02/2015
Last updated
02/02/2015
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