Individual
SHERI DIANE MARTIN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
APRN
Contact information
Practice address
225 E JACKSON AVE, JONESBORO, AR 72401-3119
(870) 207-4100
(870) 207-6581
Mailing address
6232 ALAN DR, JONESBORO, AR 72404-7647
(870) 761-1232
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
A004422
AR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
438655ZNVF
MEDICARE PTAN
AR
01
—
438655ZQQ9
MEDICARE PTAN
AR
Enumeration date
06/19/2015
Last updated
11/11/2015
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