Individual provider · Type 1 NPI

Jerry Lee Green Jr., FNP

Family Nurse Practitioner · Fort Leavenworth, KS

NPI number 1366449316 Active

Practice location

550 Pope Ave, Munson Army Health Center (attn: Mcxn-Cod, Ms. Cotton)
Fort Leavenworth, KS 66027-2332

Call (913) 684-6562 Map

Fax (913) 684-6208

Mailing address

6522 Hedge Lane Ter, Apt 206
Shawnee, KS 66226-4872

Specialties and licenses

TaxonomyCodeLicense
Family Nurse Practitioner 363LF0000XAP30006651 (WA)
Family Nurse Practitioner Primary 363LF0000X45863 (KS)

Family Nurse Practitioner: Definition to come...

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About NPI 1366449316

Jerry Lee Green Jr., FNP's National Provider Identifier is 1366449316, issued on Jul 6, 2005. The primary taxonomy on file is Family Nurse Practitioner (363LF0000X), and the practice location is in Fort Leavenworth, KS. The record was last updated on Jul 8, 2007.