Provider Demographics
NPI:1972261352
Name:MARTIN, SHONNA (PMHNP, BC)
Entity type:Individual
Prefix:
First Name:SHONNA
Middle Name:
Last Name:MARTIN
Suffix:
Gender:F
Credentials:PMHNP, BC
Other - Prefix:
Other - First Name:SHONNA
Other - Middle Name:
Other - Last Name:HORLEBEIN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PMHNP, CRNP
Mailing Address - Street 1:2441 INTERNATIONAL PARK DR
Mailing Address - Street 2:
Mailing Address - City:BIRMINGHAM
Mailing Address - State:AL
Mailing Address - Zip Code:35243-4252
Mailing Address - Country:US
Mailing Address - Phone:251-680-0890
Mailing Address - Fax:
Practice Address - Street 1:2441 INTERNATIONAL PARK DR
Practice Address - Street 2:
Practice Address - City:BIRMINGHAM
Practice Address - State:AL
Practice Address - Zip Code:35243-4252
Practice Address - Country:US
Practice Address - Phone:205-813-7403
Practice Address - Fax:205-813-7405
Is Sole Proprietor?:Yes
Enumeration Date:2021-12-02
Last Update Date:2025-01-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL1-178632363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health