NPI 1003191651

Amy Green

Practitioner Pharmacist Jackson, MS

Practice location

Address: 1497 Canton Mart Rd, Jackson, MS 39211-5435
Phone: (601) 956-2421
Fax: (601) 978-3929

Registered specialties

Pharmacist Primary

Pharmacy Service Providers Taxonomy 183500000X Licence 09898 (MS)

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Registry record

NPI: 1003191651
Entity type: Individual
Sex (as registered): Female
NPI issued: 14 Oct 2011
Record last updated: 14 Oct 2011

Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.