Individual
MICAH DESHAUN MARTIN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
AGNP-C
Contact information
Practice address
5200 HARRY HINES BLVD, DALLAS, TX 75235-7709
(214) 266-0000
Mailing address
5200 HARRY HINES BLVD, DALLAS, TX 75235-7709
(214) 590-8000
Taxonomy
Speciality
Code
Description
License number
State
363LA2200X
Adult Health Nurse Practitioner
Primary
AP136599
TX
363LG0600X
Gerontology Nurse Practitioner
AP136599
TX
Other
Enumeration date
05/07/2018
Last updated
07/03/2024
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