| NPI | 1366963795 |
|---|---|
| Former Name | JENNIFER MARIE GREEN |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LA2200X Nurse Practitioner Adult Health (Licence: TX AP134441) |
| Additional Taxonomies | 363LG0600X Nurse Practitioner Gerontology (Licence: TX AP134441) |
| Enumeration Date | 2017-07-06 |
| Last Update Date | 2018-06-06 |