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General NPI Number Information
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NPI Number | 1891459145
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Entity Type | Individual
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Provider Name | CHRISTINA GREEN LPN
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Gender | Female
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Dates
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Enumeration Date | 10/23/2021
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Last Update Date | 10/23/2021
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Provider Practice Location Address
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Address Line | 7709 YALTA WAY
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City | GAINESVILLE
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State | VA
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Zip | 20155-1983
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Country | US
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Telephone | 703-232-1424
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Fax | 703-293-5720
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Provider Business Mailing Address
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Address Line | 7709 YALTA WAY
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City | GAINESVILLE
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State | VA
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Zip | 20155-1983
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Country | US
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Telephone | 703-232-1424
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Fax | 703-293-5720
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 164W00000X
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Taxonomy Name | Licensed Practical Nurse
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License Number | 0002083977
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License Number State | VA
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