Individual
SHANDA GREEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
13901 TECHNOLOGY DR UNIT AB, OKLAHOMA CITY, OK 73134-1052
(405) 606-2727
Mailing address
PO BOX 571, PIEDMONT, OK 73078-0571
(304) 640-2264
(304) 640-2264
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
Primary
R0114706
OK
363LF0000X
Family Nurse Practitioner
Primary
228753
OK
Other
Enumeration date
11/03/2025
Last updated
06/14/2026
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