| NPI | 1386498780 |
|---|---|
| Former Name | JACQUELINE P GREEN |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LA2200X Nurse Practitioner, Adult Health (Licence: WA AP61546551) |
| Additional Taxonomies | 363LG0600X Nurse Practitioner, Gerontology (Licence: WA AP61546551) |
| 363LP2300X Nurse Practitioner, Primary Care (Licence: WA AP61546551) | |
| Enumeration Date | 2024-04-12 |
| Last Update Date | 2024-08-15 |