| Doctor Name: | MARTHA E. COUSINS |
| NPI Number: | 1598098618 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | NP |
| License Number: | 14203 |
| Business Practice Address: | 481 Concord Rd Mohawk, TN - 378105612 |
| Business Phone Number: | 4238230517 |
| Business Fax Number: | 4232353080 |
| Mailing Address: | 481 Concord Rd, MOHAWK |
| State: | TN |
| Postal Code: | 378105612 |
| Phone Number: | 4238230517 |
| Fax Number: | 4232353080 |
| NPI Enumeration Date: | 09/08/2009 |
| NPI Last Update Date: | 04/09/2013 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 363LA2200X |
| License Number: | 14203 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | TN |
| Taxonomy Type: | Physician Assistants & Advanced Practice Nursing Providers |
| Taxonomy Classification: | Nurse Practitioner |
| Taxonomy Specialization: | Adult Health |
| Taxonomy Definition: | |