| NPI | 1669890505 |
|---|---|
| Former Name | JENNIFER LYNN GREEN |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LP0200X Nurse Practitioner, Pediatrics (Licence: FL APRN9264341) |
| Additional Taxonomies | 363LP0222X Nurse Practitioner, Pediatrics, Critical Care (Licence: FL APRN9264341) |
| Enumeration Date | 2014-03-28 |
| Last Update Date | 2023-03-01 |