Individual
MRS. ALEXIS DANIELLE GREEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
DNP
Contact information
Practice address
621 MEMORIAL DR STE 502, SOUTH BEND, IN 46601-1075
(574) 647-5875
(574) 647-5878
Mailing address
3245 HEALTH DR STE 100, GRANGER, IN 46530-1380
(574) 647-3725
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
4704398971
MI
363LA2100X
Acute Care Nurse Practitioner
4704398971
MI
363LA2100X
Acute Care Nurse Practitioner
71017611A
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
300126137
—
IN
Enumeration date
03/08/2023
Last updated
03/13/2026
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