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Individual

CAROL D MARTIN

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
NP

Contact information

Practice address
1265 HIGHWAY 54 W, SUITE 409, FAYETTEVILLE, GA 30214-4548
(678) 817-6505
Mailing address
95 COLLIER RD NW, SUITE 4075, ATLANTA, GA 30309-1796
(404) 603-3543
(404) 350-8795

Taxonomy

Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
RN072776
GA

Other

Enumeration date
04/27/2009
Last updated
04/27/2009
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