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Individual

MS. KATHLEEN A. MARTIN

Active
Find providers by NPI
Individual

MS. KATHLEEN A. MARTIN

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
NP

Taxonomy

Speciality
Code
Description
License number
State
363LX0001X
Obstetrics & Gynecology Nurse Practitioner
Primary
NP88A
ID

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000010016728
REGENCE BLUE SHIELD OF ID
ID
01
—
000010016729
REGENCE BLUE SHIELD OF ID
ID
01
—
500029223
RAILROAD MEDICARE
ID
01
—
781786
DESERET
ID
05
—
805800900
—
ID
01
—
820367722A010
TRICARE
ID
01
—
820367722C012
TRICARE
ID
01
—
NPNB1
BLUE CROSS OF IDAHO
ID
Enumeration date
07/19/2006
Last updated
11/10/2012
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