Green, Annie B

Green, Annie B is an individual health care provider with primary practice located at 66 Old Airport Rd , Hattiesburg MS 39401-8382. She recently has only one registered license in Physician Assistants & Advanced Practice Nursing Providers / Family, which is considered as her primary health care specialty. Green, Annie B can be contacted via phone (601) 544-7500.

Contact Information

Primary practice address
66 Old Airport Rd Hattiesburg MS 39401-8382
Phone: (601) 544-7500
Fax: (601) 544-7524
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Family 363LF0000X R733618 Mississippi

Profile Details

NPI number 1881671931
LBN Legal business name Green, Annie B
Credentials FNP-BC
Entity Individual
Sole proprietor 1 No
Enumeration date Dec 29th, 2005
Last updated Apr 1st, 2014 - about 12 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 1881671931 NPPES
Mississippi Other 11582005 CAQH I D NUMBER
Mississippi MEDICAID 00123059 CAQH I D NUMBER

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