Tamika Green, LPN
Licensed Practical Nurse in Petersburg, VA. Individual provider (NPI-1).
NPI number1619637832
StatusActive
Last updated in NPPESDec 29, 2021
Details
- NPI
- 1619637832
- Entity type
- Individual (NPI-1)
- Name
- Tamika Green
- Credential
- LPN
- Sex
- Female
- Sole proprietor
- Yes
- Enumeration date
- Dec 29, 2021
- Certification date
- Dec 29, 2021
- Last updated
- Dec 29, 2021
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 164W00000X | Licensed Practical Nurse | 0002071854 | VA | Yes |
Practice location
514 Byrne StPetersburg, VA 23803-5002
Phone 804-721-7305
Mailing address
514 Byrne StPetersburg, VA 23803-5002
Phone 804-721-7305
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