Provider Demographics
NPI:1538697586
Name:GREEN, ASHLEY ELIZABETH (APRN)
Entity Type:Individual
Prefix:MRS
First Name:ASHLEY
Middle Name:ELIZABETH
Last Name:GREEN
Suffix:
Gender:F
Credentials:APRN
Other - Prefix:
Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:9500 KANIS RD STE 101
Mailing Address - Street 2:
Mailing Address - City:LITTLE ROCK
Mailing Address - State:AR
Mailing Address - Zip Code:72205-6358
Mailing Address - Country:US
Mailing Address - Phone:501-202-1902
Mailing Address - Fax:501-202-1512
Practice Address - Street 1:9500 KANIS RD STE 101
Practice Address - Street 2:
Practice Address - City:LITTLE ROCK
Practice Address - State:AR
Practice Address - Zip Code:72205-6358
Practice Address - Country:US
Practice Address - Phone:501-202-1902
Practice Address - Fax:501-202-1512
Is Sole Proprietor?:No
Enumeration Date:2017-06-02
Last Update Date:2017-06-02
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
ARR86539363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily