Provider Demographics
NPI:1588140453
Name:MARTIN, SHEMEKA DENISE (NP)
Entity type:Individual
Prefix:
First Name:SHEMEKA
Middle Name:DENISE
Last Name:MARTIN
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2305 W I 20 STE 140-467
Mailing Address - Street 2:
Mailing Address - City:GRAND PRAIRIE
Mailing Address - State:TX
Mailing Address - Zip Code:75052-3935
Mailing Address - Country:US
Mailing Address - Phone:469-520-5133
Mailing Address - Fax:
Practice Address - Street 1:2305 W I 20 STE 140-467
Practice Address - Street 2:
Practice Address - City:GRAND PRAIRIE
Practice Address - State:TX
Practice Address - Zip Code:75052-3935
Practice Address - Country:US
Practice Address - Phone:469-520-5133
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-07-13
Last Update Date:2025-02-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXAP137719363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily