Individual
JENNIFER J MARTIN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PA
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
004226
MI
363A00000X
Physician Assistant
PA9113129
FL
363AM0700X
Medical Physician Assistant
Primary
0110005030
VA
Other
Enumeration date
06/01/2006
Last updated
04/06/2020
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