Green, Charlotte Renae

Green, Charlotte Renae is an individual health care provider with primary practice located at 4579 S Eason Blvd , Tupelo MS 38801-6539. She recently has only one registered license in Physician Assistants & Advanced Practice Nursing Providers / Psychiatric/Mental Health, which is considered as her primary health care specialty. Green, Charlotte Renae can be contacted via phone (662) 377-7590.

Contact Information

Primary practice address
4579 S Eason Blvd Tupelo MS 38801-6539
Phone: (662) 377-7590
Fax: (662) 377-7595
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Psychiatric/Mental Health 363LP0808X R853585 Mississippi

Profile Details

NPI number 1174843742
LBN Legal business name Green, Charlotte Renae
Credentials PMHNP-BC
Entity Individual
Sole proprietor 1 No
Enumeration date Jun 7th, 2010
Last updated Jun 7th, 2010 - about 14 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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