Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 363LN0005X | Nurse Practitioner - Neonatal (Critical Care) | 22038 | TN |
NPI | 1265975536 |
---|---|
Provider Name | Mrs. Rachael Green |
First Address | Nashville, TN 37232-0005 |
Second Address | Nashville, TN 37232-0005 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 18/11/2016 |
Last Update Date | 15/10/2020 |