Green-Blair, Jean Caroll
Green-Blair, Jean Caroll is an individual health care provider with primary practice located at 1100 Loveland Blvd , Port Charlotte FL 33980-1802. 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-Blair, Jean Caroll can be contacted via phone (941) 624-7200.Contact Information
Primary practice address
1100 Loveland Blvd
Port Charlotte FL 33980-1802
Phone: (941) 624-7200
Fax: (941) 624-7202
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Physician Assistants & Advanced Practice Nursing Providers / Family | 363LF0000X | 3403762 | Florida |
Profile Details
| NPI number | 1205992450 |
|---|---|
| LBN Legal business name | Green-Blair, Jean Caroll |
| Credentials | ARNP |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Dec 29th, 2006 |
| Last updated | Aug 26th, 2013 - about 13 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.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1205992450 | NPPES |
| Florida | MEDICAID | 306537500 |
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