Provider Demographics
NPI:1417654583
Name:MARTIN, SHAMEKIA QUICK (RN, BSN, MSN, A-GNP)
Entity Type:Individual
Prefix:
First Name:SHAMEKIA
Middle Name:QUICK
Last Name:MARTIN
Suffix:
Gender:F
Credentials:RN, BSN, MSN, A-GNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 2002
Mailing Address - Street 2:
Mailing Address - City:ROCKINGHAM
Mailing Address - State:NC
Mailing Address - Zip Code:28380-2002
Mailing Address - Country:US
Mailing Address - Phone:910-334-3613
Mailing Address - Fax:
Practice Address - Street 1:915 PEE DEE RD
Practice Address - Street 2:
Practice Address - City:ABERDEEN
Practice Address - State:NC
Practice Address - Zip Code:28315-3817
Practice Address - Country:US
Practice Address - Phone:910-944-8999
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-02-09
Last Update Date:2023-02-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC5017615363LG0600X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LG0600XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerGerontology