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General NPI Number Information
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NPI Number | 1619502812
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Entity Type | Individual
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Provider Name | TANSHANICKA SHELLAMICE HELEM DNP, FNP-BC
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Gender | Female
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Dates
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Enumeration Date | 03/08/2020
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Last Update Date | 12/02/2025
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Provider Practice Location Address
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Address Line | 3261 OLD WASHINGTON RD
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City | WALDORF
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State | MD
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Zip | 20602-3223
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Country | US
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Telephone | 301-200-5790
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Fax |
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Provider Business Mailing Address
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Address Line | 3261 OLD WASHINGTON RD STE J-2020
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City | WALDORF
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State | MD
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Zip | 20602-3223
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Country | US
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Telephone | 301-200-5790
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | NP67553
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License Number State | DC
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Taxonomy #2
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Taxonomy Code | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | R143602
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License Number State | MD
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Taxonomy #3
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Taxonomy Code | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | 1136376
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License Number State | TX
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Taxonomy #4
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Taxonomy Code | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | 5017872
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License Number State | NC
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