MEDICARE: TRISHA SHETH ACNP

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	363LA2100X	Acute Care Nurse Practitioner	APRN-NP284424	GA
2	363LA2100X	Acute Care Nurse Practitioner	209007620	IL

General Provider Information

NPI Number	:	1447546296
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	TRISHA SHETH ACNP

Provider Business Mailing Address
First Line	:	2690 DERBY WALK NE
Second Line	:
City	:	BROOKHAVEN
State	:	GA
Zip	:	30319-3657
Country	:	US
Telephone Number	:	312-890-8743
Fax Number	:

Provider Business Practice Location Address
First Line	:	1605 CHANTILLY DR NE
Second Line	:
City	:	ATLANTA
State	:	GA
Zip	:	30324-3267
Country	:	US
Telephone Number	:	404-257-0006
Fax Number	:	404-851-1316

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	06/21/2011
Last Update Date	:	10/10/2025

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