Green, Alex Jonathan

Green, Alex Jonathan is an individual health care provider with primary practice located at 744 S Webster Ave , Green Bay WI 54301-3505. He recently has only one registered license in Physician Assistants & Advanced Practice Nursing Providers / Anesthesiologist Assistant, which is considered as his primary health care specialty. Green, Alex Jonathan can be contacted via phone (920) 433-3605.

Contact Information

Primary practice address
744 S Webster Ave Green Bay WI 54301-3505
Phone: (920) 433-3605
Fax: (920) 433-3589
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Anesthesiologist Assistant 367H00000X 197-17 Wisconsin

Profile Details

NPI number 1417610270
LBN Legal business name Green, Alex Jonathan
Credentials CAA
Entity Individual
Sole proprietor 1 No
Enumeration date Oct 19th, 2021
Last updated Oct 19th, 2021 - about 4 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1417610270 NPPES
Other 32697960 NATIONAL COMMISSION CERTIFICATION ANESTHESIA ASSTS

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