Individual
DR. SHANELL S GREENE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
542 S 54TH ST, PHILADELPHIA, PA 19143-1916
(267) 904-5987
Mailing address
542 S 54TH ST, PHILADELPHIA, PA 19143-1916
(267) 904-5987
Taxonomy
Speciality
Code
Description
License number
State
251G00000X
Community Based Hospice Care Agency
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
473848614
NURSING
PA
Enumeration date
06/19/2018
Last updated
06/19/2018
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