NPI 1104154293
Teresa Diane Green
Practice location
- Address
- 415 W Gladys St, Sikeston, MO 63801-2733
- Phone
- (573) 475-9254
- Fax
- (573) 475-9254
Registered specialties
Homemaker
Primary
Registry record
- NPI
- 1104154293
- Entity type
- Individual
- Sex (as registered)
- Female
- NPI issued
- 30 Nov 2009
- Record last updated
- 30 Nov 2009
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.