Green, Desire D.

Green, Desire D. is an individual health care provider with primary practice located at 101 Potters Ln , Clarksville IN 47129-1000. She recently has 2 registered licenses in different health care specialties including Physician Assistants & Advanced Practice Nursing Providers / Nurse Practitioner, Physician Assistants & Advanced Practice Nursing Providers / Family. Physician Assistants & Advanced Practice Nursing Providers / Family is her primary health care specialty. Green, Desire D. can be contacted via phone (443) 383-9300.

Contact Information

Primary practice address
101 Potters Ln Clarksville IN 47129-1000
Phone: (443) 383-9300
Fax: (855) 866-8710
Website:
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Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Nurse Practitioner 363L00000X 71005375A Indiana
Physician Assistants & Advanced Practice Nursing Providers / Family 363LF0000X 71005375A Indiana

Profile Details

NPI number 1720475395
LBN Legal business name Green, Desire D.
Credentials Nurse Practitioner (NP)
Entity Individual
Sole proprietor 1 No
Enumeration date Apr 22nd, 2015
Last updated Nov 17th, 2022 - 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 1720475395 NPPES
Indiana MEDICAID 201288380

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