MEDICARE: DR. TANSHANICKA SHELLAMICE FELTON DNP, FNP-BC

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	363LF0000X	Family Nurse Practitioner	NP67553	DC
2	363LF0000X	Family Nurse Practitioner	1136376	TX
3	363LF0000X	Family Nurse Practitioner	5017872	NC
4	363LF0000X	Family Nurse Practitioner	R143602	MD

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1619502812
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. TANSHANICKA SHELLAMICE FELTON DNP, FNP-BC

Provider Business Mailing Address
First Line	:	3261 OLD WASHINGTON RD STE J-2020
Second Line	:
City	:	WALDORF
State	:	MD
Zip	:	20602-3223
Country	:	US
Telephone Number	:	301-200-5790
Fax Number	:

Provider Business Practice Location Address
First Line	:	3261 OLD WASHINGTON RD
Second Line	:
City	:	WALDORF
State	:	MD
Zip	:	20602-3223
Country	:	US
Telephone Number	:	301-200-5790
Fax Number	:

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

Provider Enumeration Date	:	03/08/2020
Last Update Date	:	03/11/2026

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Directions to “ DR. TANSHANICKA SHELLAMICE FELTON DNP, FNP-BC” Practice Location

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