| NPI | 1033558176 |
|---|---|
| Former Name | TREVA RENEE GREEN |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: TX AP124001) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: TX 714292) |
| 363LF0000X Nurse Practitioner, Family (Licence: TX 124001) | |
| Enumeration Date | 2013-06-21 |
| Last Update Date | 2022-07-27 |