Individual
MISS KIMBERLY CHARISE MARTIN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NP-C
Contact information
Practice address
1802 BRAEBURN DR, SALEM, VA 24153-7357
(540) 772-3400
Mailing address
2000 HEALTH PARK DR FL HP2, BRENTWOOD, TN 37027-4692
(615) 373-7600
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
0024174765
VA
363LG0600X
Gerontology Nurse Practitioner
0024174765
VA
Other
Enumeration date
04/13/2017
Last updated
01/27/2022
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