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Individual

MS. DEANNA H MARTIN

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
PA-C

Contact information

Practice address
3601 THE VANDERBILT CLINIC, NASHVILLE, TN 37232-5437
(615) 936-2000
Mailing address
719 THOMPSON LN, NASHVILLE, TN 37204-3609
(615) 936-2000

Taxonomy

Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
3585
TN
363AM0700X
Medical Physician Assistant
2249
CO

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
019245
KAISER COMMERCIAL NUMBER
CO
05
70774048
CO
Enumeration date
07/26/2006
Last updated
10/15/2020
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