Doctor Name: | LEEANN JOYCE GREEN |
NPI Number: | 1013993658 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | NURSE PRACTITIONER |
License Number: | 15096 |
Business Practice Address: | 28078 Baxter Rd Suite 314 Murrieta, CA - 925631402 |
Business Phone Number: | 9518947752 |
Business Fax Number: | |
Mailing Address: | 28078 Baxter Rd, Suite 314 MURRIETA |
State: | CA |
Postal Code: | 925631402 |
Phone Number: | 9518947752 |
Fax Number: | |
NPI Enumeration Date: | 12/15/2005 |
NPI Last Update Date: | 01/16/2013 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 363LF0000X |
License Number: | 15096 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | CA |
Taxonomy Type: | Physician Assistants & Advanced Practice Nursing Providers |
Taxonomy Classification: | Nurse Practitioner |
Taxonomy Specialization: | Family |
Taxonomy Definition: |