Provider Demographics
NPI:1770167314
Name:PARTIN, SHAE M (PNP)
Entity type:Individual
Prefix:MRS
First Name:SHAE
Middle Name:M
Last Name:PARTIN
Suffix:
Gender:F
Credentials:PNP
Other - Prefix:
Other - First Name:SHAE
Other - Middle Name:
Other - Last Name:LINGERFELT
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:387 THOMPSON HILL RD
Mailing Address - Street 2:
Mailing Address - City:RINGGOLD
Mailing Address - State:GA
Mailing Address - Zip Code:30736-8661
Mailing Address - Country:US
Mailing Address - Phone:423-774-0978
Mailing Address - Fax:
Practice Address - Street 1:2918 E WALNUT AVE
Practice Address - Street 2:
Practice Address - City:DALTON
Practice Address - State:GA
Practice Address - Zip Code:30721-8724
Practice Address - Country:US
Practice Address - Phone:706-529-4600
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-05-10
Last Update Date:2021-05-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GARN257447363LP0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPediatrics