Individual
KELYN MARTIN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
180B DEBUYS RD, BILOXI, MS 39531-4404
(228) 273-4096
(877) 796-0186
Mailing address
PO BOX 4594, BILOXI, MS 39535-4594
(228) 273-4096
(877) 796-0186
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
905175
MS
363LF0000X
Family Nurse Practitioner
905175
MS
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
200001245
—
MS
Enumeration date
07/07/2022
Last updated
05/13/2024
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