Individual provider · Type 1 NPI

Janiel J. Green, PA-C

Medical Physician Assistant · Rexburg, ID

NPI number 1114297660 Active

Practice location

36 Professional Plz, Suite #102
Rexburg, ID 83440-2049

Call (208) 356-0234 Map

Fax (208) 656-8444

Specialties and licenses

TaxonomyCodeLicense
Medical Physician Assistant Primary 363AM0700XPA-957 (ID)

Medical Physician Assistant: Definition to come...

9 other providers at this address

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About NPI 1114297660

Janiel J. Green, PA-C's National Provider Identifier is 1114297660, issued on Dec 30, 2011. The primary taxonomy on file is Medical Physician Assistant (363AM0700X), and the practice location is in Rexburg, ID. The record was last updated on Dec 30, 2011.