MEDICARE: RASHELL SHANNON GREENE

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	171100000X	Acupuncturist	2051	NC

General Provider Information

NPI Number	:	1174195564
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	RASHELL SHANNON GREENE

Provider Business Mailing Address
First Line	:	907 CHERYL LN
Second Line	:
City	:	WILMINGTON
State	:	NC
Zip	:	28405-1270
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	4004 OLEANDER DR STE 101
Second Line	:
City	:	WILMINGTON
State	:	NC
Zip	:	28403-6807
Country	:	US
Telephone Number	:	828-434-3342
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	07/14/2021
Last Update Date	:	07/14/2021

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Directions to “ RASHELL SHANNON GREENE ” Practice Location

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