Shea Elizabeth Green, PA
Physician Assistant in Scottsdale, AZ. Individual provider (NPI-1).
NPI number1164041034
StatusActive
Last updated in NPPESMar 7, 2023
Details
- NPI
- 1164041034
- Entity type
- Individual (NPI-1)
- Name
- Shea Elizabeth Green
- Credential
- PA
- Sex
- Female
- Sole proprietor
- Yes
- Enumeration date
- Apr 10, 2020
- Certification date
- May 17, 2021
- Last updated
- Mar 7, 2023
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 363A00000X | Physician Assistant | 8239 | AZ | Yes |
Practice location
8752 E Via De Commercio Ste 1Scottsdale, AZ 85258-3396
Phone 480-684-1080 · Fax 480-684-1081
Mailing address
9097 E Desert Cove Ave Ste 200Scottsdale, AZ 85260-6280
Phone 480-273-8510 · Fax 480-214-9933
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