Individual
SHANDA GREEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
8713 SW 37TH ST, OKLAHOMA CITY, OK 73179-3042
(304) 640-2264
(304) 640-2264
Mailing address
8713 SW 37TH ST, OKLAHOMA CITY, OK 73179-3042
(304) 640-2264
(304) 640-2264
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
Primary
R0114706
OK
Other
Enumeration date
11/03/2025
Last updated
11/03/2025
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