Individual
AVA DAWN GREENE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
FNP-C
Contact information
Practice address
3003 VETERANS PKWY S, MOULTRIE, GA 31788-6705
(229) 985-3422
Mailing address
4705 TWO KNOTCH CIR, LAKE PARK, GA 31636-4981
(229) 834-6453
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
RN118430
GA
Other
Enumeration date
07/31/2018
Last updated
07/31/2018
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