Individual
MRS. SHELLEY DEANNA MARTIN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CRNP- FAMILY
Contact information
Practice address
7450 ALBERT RD, BRANDYWINE, MD 20613-3035
(301) 599-0460
Mailing address
11214 MATTAPONI RD, UPPER MARLBORO, MD 20772-8211
(703) 477-9031
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
R139536
MD
Other
Enumeration date
09/19/2022
Last updated
09/19/2022
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