Individual
MRS. SHANNON LILLY GREEN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
RN
Contact information
Practice address
480 CENTRAL AVE, PEARL HARBOR, HI 96860-4908
(808) 471-1866
(808) 471-1855
Mailing address
480 CENTRAL AVE, PEARL HARBOR, HI 96860-4908
(808) 471-1866
(808) 471-1855
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
Primary
RN60816
HI
Other
Enumeration date
09/28/2012
Last updated
09/28/2012
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