Individual
NICOLE L MARTIN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
APRN
Contact information
Practice address
30 QUAKER FARMS RD STE 1, SOUTHBURY, CT 06488-2732
(203) 262-9300
(203) 264-2696
Mailing address
67 MAPLE AVE, DERBY, CT 06418-1328
Taxonomy
Speciality
Code
Description
License number
State
363LA2200X
Adult Health Nurse Practitioner
Primary
11199
CT
Other
Enumeration date
09/27/2021
Last updated
11/09/2022
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