Individual provider · Type 1 NPI

Tedean Karissa Green

Student in an Organized Health Care Education/Training Program · Detroit, MI

NPI number 1699122630 Active

Practice location

4201 Saint Antoine St # Uhc, Department Of Otolaryngology-Head And Neck Surgery
Detroit, MI 48201-2153

Call (269) 924-9783 Map

Mailing address

300 Riverfront Dr Unit 17F
Detroit, MI 48226-4578

Specialties and licenses

TaxonomyCodeLicense
Student in an Organized Health Care Education/Training Program Primary 390200000XNone listed

Student in an Organized Health Care Education/Training Program: An individual who is enrolled in an organized health care education/training program leading to a degree, certification, registration, and/or licensure to provide health care.

6 other providers at this address

Other student in an organized health care education/training program providers in Detroit

See all in Detroit →

About NPI 1699122630

Tedean Karissa Green's National Provider Identifier is 1699122630, issued on May 19, 2016. The primary taxonomy on file is Student in an Organized Health Care Education/Training Program (390200000X), and the practice location is in Detroit, MI. The record was last updated on Jul 1, 2026.