Individual
KATHY MARTIN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
M.S.
Contact information
Practice address
315 S PEARL AVE, JOPLIN, MO 64801
(417) 781-6228
(417) 781-6248
Mailing address
315 S PEARL AVE, JOPLIN, MO 64801-2538
(417) 781-6228
(417) 781-6248
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
2004008789
MO
363LA2200X
Adult Health Nurse Practitioner
Primary
2005035596
MO
363LP2300X
Primary Care Nurse Practitioner
2005035596
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1003149261
—
MO
05
—
20048789
—
MO
05
—
244
—
KS
Enumeration date
11/03/2005
Last updated
06/25/2018
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