Individual
QUINITA SHANTELL MARTIN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
NP
Contact information
Practice address
4178 SAWGRASS DR, LITHONIA, GA 30038-1255
(404) 578-2795
Mailing address
4178 SAWGRASS DR, LITHONIA, GA 30038-1255
(404) 578-2795
Taxonomy
Speciality
Code
Description
License number
State
363LA2100X
Acute Care Nurse Practitioner
Primary
RN265452
GA
Other
Enumeration date
03/25/2024
Last updated
03/25/2024
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