Individual
CHAMA ALISHA MARTIN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
RN
Contact information
Practice address
557 JOHN BAKER RD, FIELDALE, VA 24089-3340
(276) 521-2697
Mailing address
557 JOHN BAKER RD, FIELDALE, VA 24089-3340
(276) 521-2697
Taxonomy
Speciality
Code
Description
License number
State
253Z00000X
In Home Supportive Care Agency
Primary
0001234575
VA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0725176520
—
VA
Enumeration date
10/08/2018
Last updated
10/08/2018
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