Individual
SHANTELLE JANE GREENWOOD
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NURSE PRACTITIONER
Contact information
Practice address
3506 21ST ST, SUITE 607, LUBBOCK, TX 79410-1212
(806) 725-4134
(806) 723-7803
Mailing address
3420 22ND PL, LUBBOCK, TX 79410-1314
(806) 725-5844
(806) 723-6532
Taxonomy
Speciality
Code
Description
License number
State
363LA2100X
Acute Care Nurse Practitioner
Primary
623663
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
623663
NP LICENSE
TX
Enumeration date
07/24/2008
Last updated
06/16/2014
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