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Individual
KELLEY MARTIN
Active
Individual
KELLEY MARTIN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
APRN-CNP
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
R0117418
OK
363L00000X
Nurse Practitioner
Primary
202627
OK
363LA2100X
Acute Care Nurse Practitioner
202627
OK
Other
Enumeration date
06/10/2021
Last updated
12/04/2025
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