Individual
LISA MARTIN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
300 N EDWARDS ST, ENTERPRISE, AL 36330-2508
(334) 475-2342
Mailing address
300 N EDWARDS ST, ENTERPRISE, AL 36330-2508
(334) 475-2342
Taxonomy
Speciality
Code
Description
License number
State
363LA2200X
Adult Health Nurse Practitioner
Primary
1-054482
AL
363LG0600X
Gerontology Nurse Practitioner
1-054482
AL
Other
Enumeration date
05/12/2014
Last updated
10/07/2023
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