Individual
MRS. BRENDA SHORTER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NP-C, NNP-BC
Contact information
Practice address
980 JOHNSON FY RD NE STE 620, ATLANTA, GA 30342
(404) 252-9751
(678) 990-5763
Mailing address
980 JOHNSON FY RD NE STE 620, ATLANTA, GA 30342-1608
(404) 252-9751
(678) 990-5763
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
RN139907
GA
363LN0000X
Neonatal Nurse Practitioner
Primary
RN139907
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
713532283A
—
GA
05
—
713532283B
—
GA
05
—
713532283C
—
GA
Enumeration date
07/14/2005
Last updated
07/26/2018
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