Organization
NEW CHANGES LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
SHANNON MARTIN CRNP (OWNER)
(301) 804-0344
Entity
Organization
Contact information
Practice address
1406B CRAIN HWY S STE 304, GLEN BURNIE, MD 21061-4094
(301) 804-0344
Mailing address
1406B CRAIN HWY S STE 304, GLEN BURNIE, MD 21061-4094
(301) 804-0344
Taxonomy
Speciality
Code
Description
License number
State
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
—
—
Other
Enumeration date
04/08/2026
Last updated
04/08/2026
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