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1235472697
RODERICK GREEN
JACKSON, MS
NPI
1235472697
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
363LP0808X Nurse Practitioner, Psych/Mental Health
(Licence: MS r828349)
Enumeration Date
2013-04-03
Last Update Date
2015-07-29
Business Address
-- RODERICK GREEN pmhnp
2500 N STATE ST
JACKSON, MS 39216-4500
Phone number: 601-815-5815
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Mailing Address
-- RODERICK GREEN pmhnp
2500 N STATE ST
JACKSON, MS 39216-4500
Phone number: 601-984-5815
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