Individual
MS. JESSICA EILEEN MARTIN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MSN, RN, FNP-BC
Contact information
Practice address
506 4TH ST, LA GRANDE, OR 97850-1906
(541) 663-3138
Mailing address
8705 NW 82ND ST APT A, KANSAS CITY, MO 64152-4145
(816) 517-4877
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
2004020222
MO
363LF0000X
Family Nurse Practitioner
Primary
2013002954
MO
Other
Enumeration date
01/23/2013
Last updated
08/05/2013
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