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1124636113
SHELLIE A GREEN
WATERTOWN, NY
NPI
1124636113
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Former Name
SHELLIE A COUNTRYMAN
Entity Type
Individual
Gender
Female
Sole Proprietor ?
No
Primary Taxonomy
363LF0000X Nurse Practitioner, Family
(Licence: NY F346037-1)
Enumeration Date
2020-07-16
Last Update Date
2020-07-17
Business Address
SHELLIE A GREEN
160 STONE ST
WATERTOWN, NY 13601-3250
Phone number: 585-371-8373
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Mailing Address
SHELLIE A GREEN
2697 MAIN ST
BUFFALO, NY 14214-1701
Phone number: 585-371-8373
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