Individual
JYLL K GREEN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
ANP
Contact information
Practice address
2105 E 88TH AVENUE, ANCHORAGE, AK 99507
(907) 248-2482
(907) 248-0045
Mailing address
2105 E 88TH AVENUE, ANCHORAGE, AK 99507
(907) 248-2482
(907) 248-0045
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
859
AK
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1022671
—
AK
Enumeration date
12/13/2006
Last updated
11/21/2013
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