Doctor Name: | MS. DEBORAH CHRISTINE MARTIN |
NPI Number: | 1639384506 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | RNC, NNP |
License Number: | 112468 |
Business Practice Address: | 9515 Holy Cross Ln Breese, IL - 622303618 |
Business Phone Number: | 6185264511 |
Business Fax Number: | |
Mailing Address: | 125 Jardin Cercle, HIGHLAND |
State: | IL |
Postal Code: | 622494708 |
Phone Number: | 6189788174 |
Fax Number: | |
NPI Enumeration Date: | 05/13/2007 |
NPI Last Update Date: | 04/08/2015 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 363LN0005X |
License Number: | 112468 |
Healthcare Provider Taxonomy: (Secondary) | N |
State: | MO |
Taxonomy Type: | Physician Assistants & Advanced Practice Nursing Providers |
Taxonomy Classification: | Nurse Practitioner |
Taxonomy Specialization: | Neonatal, Critical Care |
Taxonomy Definition: |