Green, Marcia W

Green, Marcia W is an individual health care provider with primary practice located at 520 E Douglas Blvd , Tyler TX 75702-8307. She recently has only one registered license in Physician Assistants & Advanced Practice Nursing Providers / Nurse Practitioner, which is considered as her primary health care specialty. Green, Marcia W can be contacted via phone (903) 593-1721.

Contact Information

Primary practice address
520 E Douglas Blvd Tyler TX 75702-8307
Phone: (903) 593-1721
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Nurse Practitioner 363L00000X 660992 Texas

Profile Details

NPI number 1134163868
LBN Legal business name Green, Marcia W
Credentials Family Nurse Practitioner (FNP)
Entity Individual
Sole proprietor 1 No
Enumeration date Jun 15th, 2006
Last updated Oct 13th, 2014 - about 10 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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Identifiers

StateTypeNumberIssuer
All States NPI 1134163868 NPPES
Texas MEDICAID 202278201

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