| Mr Jerry Lee Green Jr, FNP | |
|
550 Pope Ave, Munson Army Health Center (attn: Mcxn-cod, Ms. Cotton), Fort Leavenworth, KS 66027-2332 | |
| (913) 684-6562 | |
| (913) 684-6208 |
| Full Name | Mr Jerry Lee Green Jr |
|---|---|
| Gender | Male |
| Speciality | Nurse Practitioner - Family |
| Location | 550 Pope Ave, Fort Leavenworth, Kansas |
| Accepts Medicare Assignments | Does not participate in Medicare Program. He may not accept medicare assignment. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1366449316 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 363LF0000X | Nurse Practitioner - Family | AP30006651 (Washington) | Secondary |
| 363LF0000X | Nurse Practitioner - Family | 45863 (Kansas) | Primary |
| Mailing Address | Practice Location Address |
|---|---|
| Mr Jerry Lee Green Jr, FNP 6522 Hedge Lane Ter, Apt 206, Shawnee, KS 66226-4872 Ph: (360) 584-3952 | Mr Jerry Lee Green Jr, FNP 550 Pope Ave, Munson Army Health Center (attn: Mcxn-cod, Ms. Cotton), Fort Leavenworth, KS 66027-2332 Ph: (913) 684-6562 |
Miss Ligia J Taylor, NURSE PRACTITIONER Nurse Practitioner Medicare: Accepting Medicare Assignments Practice Location: 132 Harry Bell Rd, Fort Leavenworth, KS 66027 Phone: 417-655-0627 | |
Alexandra Nicole Dibasilio, Nurse Practitioner Medicare: Not Enrolled in Medicare Practice Location: 315 Pope Ave Apt 8, Fort Leavenworth, KS 66027 Phone: 410-960-5206 | |
Vincent Krause, APRN Nurse Practitioner Medicare: Not Enrolled in Medicare Practice Location: 550 Pope Ave, Fort Leavenworth, KS 66027 Phone: 913-684-6000 Fax: 913-684-6612 | |
Ernest Francia Degenhardt, NURSE PRACTITIONER Nurse Practitioner Medicare: Not Enrolled in Medicare Practice Location: 550 Pope Ave, Munson Army Health Center (attn) Mcxn-cod. Ms Cotton, Fort Leavenworth, KS 66027 Phone: 913-684-6562 Fax: 913-684-6208 | |
James Lawrence Sall, FNP Nurse Practitioner Medicare: Not Enrolled in Medicare Practice Location: 550 Pope Ave, Fort Leavenworth, KS 66027 Phone: 913-684-6671 | |
Mrs. Jennifer Herriage, APRN Nurse Practitioner Medicare: Medicare Enrolled Practice Location: 550 Pope Ave, Fort Leavenworth, KS 66027 Phone: 913-684-6000 |