Provider Demographics
NPI:1912069485
Name:ARNOLD, SHELINA C (PA-A)
Entity Type:Individual
Prefix:MRS
First Name:SHELINA
Middle Name:C
Last Name:ARNOLD
Suffix:
Gender:F
Credentials:PA-A
Other - Prefix:
Other - First Name:SHELINA
Other - Middle Name:
Other - Last Name:SIU
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PA-A
Mailing Address - Street 1:4417 NORTHSIDE PKWY NW
Mailing Address - Street 2:APT. 171
Mailing Address - City:ATLANTA
Mailing Address - State:GA
Mailing Address - Zip Code:30327-5264
Mailing Address - Country:US
Mailing Address - Phone:804-363-5051
Mailing Address - Fax:
Practice Address - Street 1:677 CHURCH ST NE
Practice Address - Street 2:
Practice Address - City:MARIETTA
Practice Address - State:GA
Practice Address - Zip Code:30060-1101
Practice Address - Country:US
Practice Address - Phone:770-794-0477
Practice Address - Fax:770-794-3108
Is Sole Proprietor?:No
Enumeration Date:2006-12-14
Last Update Date:2019-08-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA4901367H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367H00000XPhysician Assistants & Advanced Practice Nursing ProvidersAnesthesiologist Assistant