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Individual

MS. ASHLEY MARIA PAYNE MARTIN

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
PA-C

Contact information

Practice address
5900 LAKE WRIGHT DR, NORFOLK, VA 23502-1871
(757) 466-8683
(757) 466-8892
Mailing address
5900 LAKE WRIGHT DR, NORFOLK, VA 23502-1871
(757) 466-8683
(757) 466-8892

Taxonomy

Speciality
Code
Description
License number
State
363AM0700X
Medical Physician Assistant
Primary
0110004381
VA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
1275961336
OPTIMA
VA
05
1275961336
VA
Enumeration date
10/28/2013
Last updated
10/21/2014
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