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Individual
TRACI LYNN MARTIN
Active
Individual
TRACI LYNN MARTIN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NP
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
28189657A
IN
363L00000X
Nurse Practitioner
71005608A
IN
363LF0000X
Family Nurse Practitioner
Primary
71005608A
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
71005608A
APN LICENSE
IN
Enumeration date
06/22/2015
Last updated
06/08/2023
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