Shedd, Glenn Clinton

Shedd, Glenn Clinton is an individual health care provider with primary practice located at 330 Hawthorne Ln , Athens GA 30606-2152. He recently has only one registered license in Physician Assistants & Advanced Practice Nursing Providers / Nurse Practitioner, which is considered as his primary health care specialty. Shedd, Glenn Clinton can be contacted via phone (706) 613-8500.

Contact Information

Primary practice address
330 Hawthorne Ln Athens GA 30606-2152
Phone: (706) 613-8500
Fax: (706) 613-8844
Website:
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Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Nurse Practitioner 363L00000X RN117525 Georgia

Profile Details

NPI number 1720074339
LBN Legal business name Shedd, Glenn Clinton
Credentials Family Nurse Practitioner (FNP)
Entity Individual
Sole proprietor 1 No
Enumeration date Sep 20th, 2005
Last updated Oct 18th, 2023 - about last year

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1720074339 NPPES
Georgia Other 202I507833 MEDICARE PTAN
Georgia MEDICAID 000804427B MEDICARE PTAN

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