Individual
JULIE RENEE MARTIN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RN, FNP, PNP
Contact information
Practice address
2401 GILLHAM RD, KANSAS CITY, MO 64108-4619
(816) 234-3255
(816) 234-3701
Mailing address
2401 GILLHAM RD, KANSAS CITY, MO 64108-4619
(816) 234-3255
(816) 234-3701
Taxonomy
Speciality
Code
Description
License number
State
363LP0200X
Pediatric Nurse Practitioner
Primary
114829
MO
363LP0200X
Pediatric Nurse Practitioner
45543
KS
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
425777901
—
MO
Enumeration date
05/11/2006
Last updated
04/19/2016
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