Provider Demographics
NPI:1235717240
Name:MARTINOVICH, SHAYNA (MSN, CNM, BC-WHNP)
Entity type:Individual
Prefix:
First Name:SHAYNA
Middle Name:
Last Name:MARTINOVICH
Suffix:
Gender:F
Credentials:MSN, CNM, BC-WHNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:223 TREYBURN WAY
Mailing Address - Street 2:
Mailing Address - City:ARNOLD
Mailing Address - State:MD
Mailing Address - Zip Code:21012-2576
Mailing Address - Country:US
Mailing Address - Phone:301-908-5940
Mailing Address - Fax:
Practice Address - Street 1:2003 MEDICAL PKWY STE G50
Practice Address - Street 2:
Practice Address - City:ANNAPOLIS
Practice Address - State:MD
Practice Address - Zip Code:21401-3067
Practice Address - Country:US
Practice Address - Phone:443-481-4400
Practice Address - Fax:410-573-1097
Is Sole Proprietor?:No
Enumeration Date:2021-03-31
Last Update Date:2024-12-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDR189306367A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367A00000XPhysician Assistants & Advanced Practice Nursing ProvidersAdvanced Practice Midwife