Individual
DINA MARIE MARTIN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RN, AGNP
Contact information
Practice address
171 MONROE LN, LEXINGTON, SC 29072-3904
(803) 957-0500
Mailing address
PO BOX 609, LEXINGTON, SC 29071-0609
Taxonomy
Speciality
Code
Description
License number
State
363LG0600X
Gerontology Nurse Practitioner
Primary
AG08190135
SC
Other
Enumeration date
09/27/2019
Last updated
10/15/2021
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