Green, Nicole L
Green, Nicole L is an sole proprietor health care provider with primary practice located at 26218 Newport Ave , Loma Linda CA 92354-4120. She recently has only one registered license in Other Service Providers / Contractor, which is considered as her primary health care specialty. Green, Nicole L can be contacted via phone (909) 677-5111.Contact Information
Primary practice address
26218 Newport Ave
Loma Linda CA 92354-4120
Phone: (909) 677-5111
Fax:
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Other Service Providers / Contractor | 171W00000X | Nevada |
Profile Details
| NPI number | 1902259328 |
|---|---|
| LBN Legal business name | Green, Nicole L |
| Credentials | |
| Entity | Individual |
| Sole proprietor 1 | Yes |
| Enumeration date | Jul 20th, 2016 |
| Last updated | Aug 1st, 2024 - about 2 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 | 1902259328 | NPPES |
| Nevada | MEDICAID | 171W00000X |
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