Green, Sparkle

Green, Sparkle is an individual health care provider with primary practice located at 173 Nw Albritton Ln , Lake City FL 32055-4451. 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, Sparkle can be contacted via phone (386) 755-4020.

Contact Information

Primary practice address
173 Nw Albritton Ln Lake City FL 32055-4451
Phone: (386) 755-4020
Fax: (386) 752-9143
Website:
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Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Nurse Practitioner 363L00000X 1181972 Florida

Profile Details

NPI number 1487683074
LBN Legal business name Green, Sparkle
Credentials ARNP
Entity Individual
Sole proprietor 1 No
Enumeration date Jul 3rd, 2006
Last updated Mar 19th, 2014 - about 11 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 1487683074 NPPES
Florida MEDICAID 033364600
Florida Other 1181972

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