Individual
CAROL ANN MARTIN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
N.P.
Contact information
Practice address
1541 KINGS HWY, SHREVEPORT, LA 71103-4228
(318) 626-0000
(318) 629-4833
Mailing address
1512 W KIRBY PL, SHREVEPORT, LA 71103-3822
(318) 626-0177
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
AP03902
LA
363L00000X
Nurse Practitioner
RN051917
LA
363LW0102X
Women's Health Nurse Practitioner
Primary
AP03902
LA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1369977
—
LA
Enumeration date
07/20/2006
Last updated
03/03/2023
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