Provider Demographics
NPI:1245868009
Name:NORFLEET, SHANTIAH SHANEE (PMHNP)
Entity type:Individual
Prefix:MRS
First Name:SHANTIAH
Middle Name:SHANEE
Last Name:NORFLEET
Suffix:
Gender:F
Credentials:PMHNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7681 COLONIAL BEACH RD
Mailing Address - Street 2:
Mailing Address - City:PASADENA
Mailing Address - State:MD
Mailing Address - Zip Code:21122-3206
Mailing Address - Country:US
Mailing Address - Phone:443-845-0865
Mailing Address - Fax:
Practice Address - Street 1:1600 BUSH ST
Practice Address - Street 2:
Practice Address - City:BALTIMORE
Practice Address - State:MD
Practice Address - Zip Code:21230-2021
Practice Address - Country:US
Practice Address - Phone:443-845-0865
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-03-28
Last Update Date:2024-03-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDR185279363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
MD47-QAA-009195-01OtherLIABILITY INSURANCE