Doctor Name: | LISA H. MARTIN |
NPI Number: | 1063677987 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | FNP |
License Number: | R043677 |
Business Practice Address: | 3 Mountainview Dr Fort Kent, ME - 047431614 |
Business Phone Number: | 2078343971 |
Business Fax Number: | 2078343837 |
Mailing Address: | 10 Carter St., Po Box 309 EAGLE LAKE |
State: | ME |
Postal Code: | 047390309 |
Phone Number: | 2074445973 |
Fax Number: | 2074445520 |
NPI Enumeration Date: | 07/21/2008 |
NPI Last Update Date: | 04/25/2013 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 363LF0000X |
License Number: | R043677 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | ME |
Taxonomy Type: | Physician Assistants & Advanced Practice Nursing Providers |
Taxonomy Classification: | Nurse Practitioner |
Taxonomy Specialization: | Family |
Taxonomy Definition: |