Individual
NICOLE MARTIN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
1090 COMMERCE DR, PRESCOTT, AZ 86305-3700
(480) 926-7800
Mailing address
1090 COMMERCE DR, PRESCOTT, AZ 86305-3700
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
7848
AZ
363AM0700X
Medical Physician Assistant
7848
AZ
Other
Enumeration date
05/20/2020
Last updated
09/25/2025
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