Individual
BRENT A MARTIN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
APNP
Contact information
Practice address
2809 N PARK DRIVE LN, APPLETON, WI 54911-1603
(920) 380-4999
(920) 380-4961
Mailing address
122 E COLLEGE AVE, APPLETON, WI 54911-5794
(920) 996-3264
(920) 830-5970
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
201119
WI
363LF0000X
Family Nurse Practitioner
Primary
8290
WI
Other
Enumeration date
01/11/2018
Last updated
03/16/2018
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