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Individual

MARTHA KATE MCKEMIE LILLETHUN

Active
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Individual

MARTHA KATE MCKEMIE LILLETHUN

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
FNP

Taxonomy

Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
214924
NC
363LF0000X
Family Nurse Practitioner
Primary
5005613
NC

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
NC9622B
PTAN
NC
Enumeration date
05/17/2012
Last updated
02/06/2020
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