Provider Demographics
NPI:1528218625
Name:SHELVER, MARTHA G (NP)
Entity Type:Individual
Prefix:MS
First Name:MARTHA
Middle Name:G
Last Name:SHELVER
Suffix:
Gender:F
Credentials:NP
Other - Prefix:MS
Other - First Name:MARTHA
Other - Middle Name:G
Other - Last Name:WILLIAMSON
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:RN
Mailing Address - Street 1:PO BOX 5010
Mailing Address - Street 2:
Mailing Address - City:MINOT
Mailing Address - State:ND
Mailing Address - Zip Code:58702-5010
Mailing Address - Country:US
Mailing Address - Phone:701-857-3655
Mailing Address - Fax:701-857-3656
Practice Address - Street 1:101 3RD AVE. S.W.
Practice Address - Street 2:
Practice Address - City:MINOT
Practice Address - State:ND
Practice Address - Zip Code:58701-3380
Practice Address - Country:US
Practice Address - Phone:701-857-5650
Practice Address - Fax:701-857-5031
Is Sole Proprietor?:No
Enumeration Date:2008-09-25
Last Update Date:2014-12-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IDNP-1040A363LA2100X
NDR41244363LA2100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2100XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAcute Care