| Doctor Name: | MS. TERESA DIANE GREEN |
| NPI Number: | 1104154293 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | |
| License Number: | 19920393 |
| Business Practice Address: | 415 W Gladys St Sikeston, MO - 638012733 |
| Business Phone Number: | 5734759254 |
| Business Fax Number: | 5734759254 |
| Mailing Address: | 415 W Gladys St, SIKESTON |
| State: | MO |
| Postal Code: | 638012733 |
| Phone Number: | 5734759254 |
| Fax Number: | 5734759254 |
| NPI Enumeration Date: | 11/30/2009 |
| NPI Last Update Date: | 11/30/2009 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 376J00000X |
| License Number: | 19920393 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | MO |
| Taxonomy Type: | Nursing Service Related Providers |
| Taxonomy Classification: | Homemaker |
| Taxonomy Specialization: | |
| Taxonomy Definition: | An individual who provides general household activities such as meal preparation, laundry, and light housekeeping, when the individual regularly responsible for these activities is temporarily absent or unable to provide for himself. Homemakers must meet the state defined training standards. |