Individual
MRS. ALEXA GREEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LPN
Contact information
Practice address
101 S MOORE AVE, CLAREMORE, OK 74017-5091
(918) 342-6520
(918) 342-6613
Mailing address
101 S MOORE AVE, CLAREMORE, OK 74017-5091
(918) 342-6520
(918) 342-6613
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
L0069174
OK
Other
Enumeration date
05/20/2022
Last updated
05/20/2022
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