Individual
LORI ANN MARTIN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CNM
Contact information
Practice address
1929 W LINCOLN AVE, GOSHEN, IN 46526-5909
(574) 849-4646
Mailing address
64444A STATE ROAD 19, GOSHEN, IN 46526-9421
(574) 849-4646
Taxonomy
Speciality
Code
Description
License number
State
176B00000X
Midwife
Primary
09000372A
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
09000372A
NURSE MIDWIFE LICENSE NUMBER
IN
Enumeration date
04/30/2021
Last updated
04/30/2021
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