Martin, Shelley Charmaine
Martin, Shelley Charmaine is an individual health care provider with primary practice located at 1240 Jesse Jewell Pkwy Se Ste 500 , Gainesville GA 30501-3861. She recently has 2 registered licenses in different health care specialties including Physician Assistants & Advanced Practice Nursing Providers / Nurse Practitioner, Physician Assistants & Advanced Practice Nursing Providers / Gerontology. Physician Assistants & Advanced Practice Nursing Providers / Nurse Practitioner is her primary health care specialty. Martin, Shelley Charmaine can be contacted via phone (770) 536-9864.Contact Information
Primary practice address
1240 Jesse Jewell Pkwy Se Ste 500
Gainesville GA 30501-3861
Phone: (770) 536-9864
Fax: (770) 297-5025
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Physician Assistants & Advanced Practice Nursing Providers / Nurse Practitioner | 363L00000X | 1-086060 | Alabama |
| Physician Assistants & Advanced Practice Nursing Providers / Gerontology | 363LG0600X | 1-086060 | Alabama |
| Physician Assistants & Advanced Practice Nursing Providers / Nurse Practitioner | 363L00000X | GAA-NP001186 | Georgia |
Profile Details
| NPI number | 1003363201 |
|---|---|
| LBN Legal business name | Martin, Shelley Charmaine |
| Credentials | Certified Nurse Practitioner (CNP) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Sep 6th, 2016 |
| Last updated | Dec 12th, 2023 - about 3 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1003363201 | NPPES |
| Alabama | MEDICAID | 226376 |
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