Individual
JANELL DIANNE MARTIN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CRNA
Contact information
Practice address
6000 HOSPITAL DR, HANNIBAL, MO 63401-6887
(573) 248-1300
(573) 248-5196
Mailing address
PO BOX 551, HANNIBAL, MO 63401-0551
(573) 248-5115
(573) 248-5196
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
093508
MO
367500000X
Certified Registered Nurse Anesthetist
SRA 100003
CO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
71438530
—
CO
Enumeration date
09/12/2007
Last updated
07/11/2019
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