Individual
JENNIFER LYNN MARTIN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PHYSICIAN ASSISTANT
Contact information
Practice address
34020 7 MILE RD STE 101, LIVONIA, MI 48152-3093
(248) 900-1555
(248) 516-5017
Mailing address
PO BOX 30148, BELFAST, ME 04915-2053
(888) 488-8289
(502) 919-9780
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
5601004665
MI
363A00000X
Physician Assistant
PA 9108374
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1225256928
—
MI
Enumeration date
04/20/2007
Last updated
02/27/2024
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