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MELISSA GREEN CRNA

>> Nurse Anesthetist, Certified Registered >> Physician Assistants & Advanced Practice Nursing Providers

Registrant NPI Number: 1144258989

Individual Registrant:
 MELISSA  GREEN CRNA
Gender: F
Not Sole Proprietor

Location and contact information for practice:
5080 MOGOLLON RIM DR  LAKESIDE, AZ 85929-5530 US
Tel: 480-297-5926  Fax: --

Contact information for business:
5080 MOGOLLON RIM DR  LAKESIDE, AZ 85929-5530 US
Tel: 480-297-5926  Fax: --

Registration Information:
NPI: 1144258989
Entity Type: Individual

Specialty information:

PrimaryCodeCategory/DescriptionStateLicense Number
Y367500000XPhysician Assistants & Advanced Practice Nursing Providers
Nurse Anesthetist, Certified Registered
AZRN156511

Legacy codes, insurance codes and state license numbers:

IssuerNumberStateType
200513500IN05
MEDICARE PROVIDERZ142693AZ01




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