Doctor Name: | JOANN B MARTIN |
NPI Number: | 1306039052 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | ARNP |
License Number: | 5273P |
Business Practice Address: | 130 Kate Ireland Drive Hyden, KY - 417498500 |
Business Phone Number: | 6066722901 |
Business Fax Number: | 6066722943 |
Mailing Address: | 130 Kate Ireland Drive, HYDEN |
State: | KY |
Postal Code: | 417498500 |
Phone Number: | 6066722901 |
Fax Number: | 6066722942 |
NPI Enumeration Date: | 08/24/2007 |
NPI Last Update Date: | 02/14/2008 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 363LF0000X |
License Number: | 5273P |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | KY |
Taxonomy Type: | Physician Assistants & Advanced Practice Nursing Providers |
Taxonomy Classification: | Nurse Practitioner |
Taxonomy Specialization: | Family |
Taxonomy Definition: |