Individual
SUSAN C MARTIN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
FNP-BC
Contact information
Practice address
1385 S HIGHLAND AVE STE B1, JACKSON, TN 38301-7547
(314) 270-4707
(731) 427-0995
Mailing address
1385 S HIGHLAND AVE STE B1, JACKSON, TN 38301-7547
(314) 270-4707
(731) 427-0995
Taxonomy
Speciality
Code
Description
License number
State
363LP2300X
Primary Care Nurse Practitioner
Primary
APN11327
TN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
3709355
—
TN
Enumeration date
10/04/2005
Last updated
03/07/2023
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