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Individual

SHEA ELIZABETH GREEN

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
PA

Contact information

Practice address
8752 E VIA DE COMMERCIO STE 1, SCOTTSDALE, AZ 85258-3396
(480) 684-1080
(480) 684-1081
Mailing address
9097 E DESERT COVE AVE STE 200, SCOTTSDALE, AZ 85260-6280
(480) 273-8510
(480) 214-9933

Taxonomy

Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
8239
AZ

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
085142
AZ
Enumeration date
04/10/2020
Last updated
03/07/2023
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