Doctor Name: | MRS. NOVETTE SANDRA GREEN |
NPI Number: | 1083698476 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | ARNP |
License Number: | 9230252 |
Business Practice Address: | 12959 Palms West Dr Suite 120 Loxahatchee, FL - 334704937 |
Business Phone Number: | 5617538888 |
Business Fax Number: | 5617955004 |
Mailing Address: | 12959 Palms West Dr, Suite 120 LOXAHATCHEE |
State: | FL |
Postal Code: | 334704937 |
Phone Number: | 5617538888 |
Fax Number: | 5617955004 |
NPI Enumeration Date: | 11/30/2005 |
NPI Last Update Date: | 10/08/2009 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 363LP0200X |
License Number: | 9230252 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | FL |
Taxonomy Type: | Physician Assistants & Advanced Practice Nursing Providers |
Taxonomy Classification: | Nurse Practitioner |
Taxonomy Specialization: | Pediatrics |
Taxonomy Definition: |