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Individual

SHUNQUITA GREENE

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
RN

Contact information

Practice address
175 GWINNETT DR, LAWRENCEVILLE, GA 30046-8444
(678) 209-2394
Mailing address
5131 E SHORE DR SW, CONYERS, GA 30094-4713

Taxonomy

Speciality
Code
Description
License number
State
163WC0200X
Critical Care Medicine Registered Nurse
209777
GA
163WP0809X
Adult Psychiatric/Mental Health Registered Nurse
209777
GA
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
209777
GA

Other

Enumeration date
03/02/2022
Last updated
11/04/2023
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