MEDICARE: LAMONICA ALNETA GREEN

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	171M00000X	Case Manager/Care Coordinator

General Provider Information

NPI Number	:	1912762840
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	LAMONICA ALNETA GREEN

Provider Business Mailing Address
First Line	:	11301 CIMARRON DR
Second Line	:
City	:	OKLAHOMA CITY
State	:	OK
Zip	:	73162-2344
Country	:	US
Telephone Number	:	810-394-2353
Fax Number	:

Provider Business Practice Location Address
First Line	:	1418 LINWOOD BLVD
Second Line	:
City	:	OKLAHOMA CITY
State	:	OK
Zip	:	73106-5022
Country	:	US
Telephone Number	:	405-601-0295
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	02/20/2024
Last Update Date	:	02/20/2024

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Directions to “ LAMONICA ALNETA GREEN ” Practice Location

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