| Doctor Name: | RONALD D GREEN |
| NPI Number: | 1053661090 |
| Entity Type Code: | Individual (1) |
| Gender: | M |
| Credentials: | RN |
| License Number: | RN0000190352 |
| Business Practice Address: | 709 Middle Creek Rd Sevierville, TN - 378625047 |
| Business Phone Number: | 8654531032 |
| Business Fax Number: | 8654292689 |
| Mailing Address: | 709 Middle Creek Rd, SEVIERVILLE |
| State: | TN |
| Postal Code: | 378625047 |
| Phone Number: | 8654531032 |
| Fax Number: | 8654292689 |
| NPI Enumeration Date: | 09/18/2012 |
| NPI Last Update Date: | 09/18/2012 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 163WC1500X |
| License Number: | RN0000190352 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | TN |
| Taxonomy Type: | Nursing Service Providers |
| Taxonomy Classification: | Registered Nurse |
| Taxonomy Specialization: | Community Health |
| Taxonomy Definition: | |