Individual
SHANNON E MARTIN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
FNP-BC
Contact information
Practice address
1012 ROUTE 36, ATLANTIC HIGHLANDS, NJ 07716-2469
(732) 291-3865
Mailing address
1012 ROUTE 36, ATLANTIC HIGHLANDS, NJ 07716-2469
(732) 291-3865
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
26NJ00620300
NJ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0018104
—
NJ
Enumeration date
02/25/2016
Last updated
12/27/2016
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