Provider Demographics
NPI:1225735590
Name:MARTIN-PINKARD, SHEILA (FNP, PHN, MSN)
Entity type:Individual
Prefix:
First Name:SHEILA
Middle Name:
Last Name:MARTIN-PINKARD
Suffix:
Gender:F
Credentials:FNP, PHN, MSN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 691092
Mailing Address - Street 2:
Mailing Address - City:STOCKTON
Mailing Address - State:CA
Mailing Address - Zip Code:95269-1092
Mailing Address - Country:US
Mailing Address - Phone:209-740-6436
Mailing Address - Fax:
Practice Address - Street 1:2115 AUTUMN OAK PL
Practice Address - Street 2:
Practice Address - City:STOCKTON
Practice Address - State:CA
Practice Address - Zip Code:95209-4229
Practice Address - Country:US
Practice Address - Phone:209-740-6436
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-02-07
Last Update Date:2024-07-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA95071285163W00000X
CA95028898363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No163W00000XNursing Service ProvidersRegistered Nurse