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Individual
GLENN CLINTON SHEDD
Active
Individual
GLENN CLINTON SHEDD
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
FNP
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
RN117525
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
000804427B
—
GA
01
—
202I507833
MEDICARE PTAN
GA
Enumeration date
09/20/2005
Last updated
10/18/2023
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