Individual
MRS. SHELLY LYNN GREEN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
APRN
Contact information
Practice address
1321 W. 7TH STREET, STILLWATER, OK 74074
(405) 372-8200
(405) 743-2619
Mailing address
8 N. TAWANA DRIVE, SHAWNEE, OK 74804
(405) 205-8855
(405) 205-8855
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
F06192445
OK
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
2008873160A
—
OK
Enumeration date
07/01/2019
Last updated
01/27/2020
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