Individual
FELICA LANETA GREEN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
1102 W PRESIDENT AVE, GREENWOOD, MS 38930-2831
(662) 466-1691
Mailing address
1102 W PRESIDENT AVE, GREENWOOD, MS 38930-2831
(662) 466-1691
Taxonomy
Speciality
Code
Description
License number
State
347C00000X
Private Vehicle
Primary
—
—
376K00000X
Nurse's Aide
57890
MS
Other
Enumeration date
08/21/2024
Last updated
08/21/2024
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