Individual
ELANIE DESHEA MARTENS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
FNP-BC
Contact information
Practice address
3420 BRUCE RDG, CLOVER, SC 29710-6018
(417) 350-9775
Mailing address
3420 BRUCE RDG, CLOVER, SC 29710-6018
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
2021025116
MO
363LF0000X
Family Nurse Practitioner
Primary
30164
SC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
420098531
—
MO
Enumeration date
06/30/2021
Last updated
04/29/2026
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