Individual
INDIA MARTIN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
FNP-C
Contact information
Practice address
870 MAIN ST, FAYETTE, MS 39069-5695
(601) 786-3401
Mailing address
103 RUSHING ST, NATCHEZ, MS 39120-2212
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
903780
MS
Other
Enumeration date
03/31/2020
Last updated
03/31/2020
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