Individual
VICTORIA J SHELLEM
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CRNP
Contact information
Practice address
2000 MEDICAL PKWY, SUITE 200, ANNAPOLIS, MD 21401-3742
(443) 481-5300
(443) 481-6705
Mailing address
PO BOX 12622, BELFAST, ME 04915-4017
(443) 481-6573
(443) 481-6515
Taxonomy
Speciality
Code
Description
License number
State
363LA2200X
Adult Health Nurse Practitioner
Primary
R153442
MD
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
025825300
—
MD
01
—
11995694
COUNCIL FOR AFFORDABLE QUALITY HEALTHCARE
MD
01
—
169723ZCU2
MEDICARE GROUP MEMBER PTAN
MD
01
—
8057972
AETNA HMO
MD
01
—
9284514
AETNA PPO
MD
01
—
95586303
BCBS MD
MD
01
—
95586304
BCBS
MD
01
—
95586305
BCBS
MD
01
—
V8080009
BCBS
DC
01
—
V8380009
BCBS
DC
01
—
V8740009
BCBS
DC
Enumeration date
08/20/2009
Last updated
12/05/2013
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