Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.

Miss. Shaquanda Shantivus Gordon, PMHNP-BC

Individual provider Psychiatric/Mental Health Nurse Practitioner · NPI 1891475430

Miss. Shaquanda Shantivus Gordon, PMHNP-BC is a Nurse Practitioner in Fairburn, Georgia. Qualified in 2023, 3 years ago. Practices with Brave Health Medical Group, PA, a 94-clinician group and accepts Medicare assignment. Licensed in Georgia.

Years since qualifying
3
Licensed in
GA
In the registry since
2023
What do these letters mean?
PMHNP-BC — Psychiatric-Mental Health Nurse Practitioner, Board Certified
A board-certified psychiatric nurse practitioner.

See every abbreviation used in this directory →

Practice location Address checks out

825 Belmar Pass
Fairburn, GA 30213-4482
Phone: (229) 603-2601
Show map & directions

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Psychiatric/Mental Health Nurse Practitioner (primary) Taxonomy 363LP0808X · Licence 2023060174 (GA)

Record details

NPI number1891475430
Entity typeIndividual (Type 1)
GenderFemale
Credentials PMHNP-BC
Sole proprietorNo
NPI enumeratedJuly 19, 2023
Last updated in NPPESJuly 19, 2023
Certification dateJuly 19, 2023

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyNURSE PRACTITIONER
Medical schoolOTHER
Graduated 2023 (3 years in practice)
Group practice Brave Health Medical Group, Pa — 94 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount
Practice locations2 on file with Medicare

Other providers in Fairburn