Individual
AMANDA LEE MARTIN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NP
Contact information
Practice address
1601 S MAIN ST, FALL RIVER, MA 02724-2107
(508) 678-0004
(508) 678-6970
Mailing address
200 MILL RD, FAIRHAVEN, MA 02719-5252
(508) 973-2000
(508) 973-2001
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
RN2302945
MA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
RN2302945
LICENSE
MA
Enumeration date
04/14/2022
Last updated
04/14/2022
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