| Doctor Name: | JANIS KAY GREEN |
| NPI Number: | 1306881636 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | ARNP |
| License Number: | R047186 |
| Business Practice Address: | Gulf Coast Outpatient Clinic, Naval Support Activity Pc 101 Vernon Ave Ste 387 Panama City Beach, FL - 324077018 |
| Business Phone Number: | 8506307000 |
| Business Fax Number: | |
| Mailing Address: | Gulf Coast Outpatient Clinic, Naval Support Activity Pc, 101 Vernon Ave Ste 387 PANAMA CITY BEACH |
| State: | FL |
| Postal Code: | 324077018 |
| Phone Number: | 8506307000 |
| Fax Number: | |
| NPI Enumeration Date: | 06/19/2006 |
| NPI Last Update Date: | 07/08/2007 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 363LF0000X |
| License Number: | R047186 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | ME |
| Taxonomy Type: | Physician Assistants & Advanced Practice Nursing Providers |
| Taxonomy Classification: | Nurse Practitioner |
| Taxonomy Specialization: | Family |
| Taxonomy Definition: | |