Individual
TAMARA NICHOLE MARTIN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LPN
Contact information
Practice address
1820 BENTBROOKE TRL, LAWRENCEVILLE, GA 30043-2675
(901) 922-9386
Mailing address
1820 BENTBROOKE TRL, LAWRENCEVILLE, GA 30043-2675
(901) 922-9386
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
LPN087309
GA
Other
Enumeration date
08/06/2013
Last updated
08/06/2013
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