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Individual

ASHTON MARTIN

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
RN

Contact information

Practice address
1041 E SULLIVAN ST, KINGSPORT, TN 37660-5242
(423) 360-6227
Mailing address
1041 E SULLIVAN ST, KINGSPORT, TN 37660-5242
(423) 360-6227

Taxonomy

Speciality
Code
Description
License number
State
163WC1500X
Community Health Registered Nurse
Primary
RN0000180294
TN

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
3911774
MEDICARE
TN
01
B58933
UPIN
TN
Enumeration date
05/16/2013
Last updated
05/16/2013
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