Individual
MS. MARTHA M CLINTON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
FNP-BC
Contact information
Practice address
565 N. ROBINSON STREET, SENATOBIA, MS 38668
(662) 560-4313
(662) 560-4383
Mailing address
1445 ROSS AVE STE 1400, DALLAS, TX 75202-2703
(469) 893-6580
(469) 893-7580
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
R672491
MS
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
11618104
CAQH
MS
Enumeration date
05/11/2006
Last updated
05/30/2018
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