Individual
MICHELLE NICKELATTI GREEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
2710 S RIFE MEDICAL LN, ROGERS, AR 72758-1452
(479) 338-8000
(479) 986-3448
Mailing address
PO BOX 776084, CHICAGO, IL 60677-6084
(479) 338-8000
(479) 986-3448
Taxonomy
Speciality
Code
Description
License number
State
363AM0700X
Medical Physician Assistant
Primary
PA-1488
AR
363AM0700X
Medical Physician Assistant
PA09869
TX
Other
Enumeration date
06/15/2015
Last updated
04/09/2026
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