Individual
JESSICA GREEN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
RD
Contact information
Practice address
1424 FRESHWATER CT, WAKE FOREST, NC 27587-6262
(919) 332-3722
Mailing address
1424 FRESHWATER CT, WAKE FOREST, NC 27587-6262
(919) 332-3722
Taxonomy
Speciality
Code
Description
License number
State
133V00000X
Registered Dietitian
Primary
L002312
NC
Other
Enumeration date
11/09/2015
Last updated
11/09/2015
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