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1457075889
CHANTEL MARIE GREEN
JEFFERSON CITY, MO
NPI
1457075889
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
No
Primary Taxonomy
363LF0000X Nurse Practitioner, Family
(Licence: MO 2022037794)
Enumeration Date
2022-09-29
Last Update Date
2023-06-28
Business Address
CHANTEL MARIE GREEN FNP
1241 W STADIUM BLVD
JEFFERSON CITY, MO 65109-6023
Phone number: 573-635-5264
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Mailing Address
CHANTEL MARIE GREEN FNP
6117 ROLING RD
JEFFERSON CITY, MO 65101-8987
Phone number: 573-680-2895
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