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Individual

MS. NICOLE MARTIN

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
APRN

Contact information

Practice address
3250 NE 1ST AVE APT 504, MIAMI, FL 33137-4088
(305) 340-9002
Mailing address
1382 GAYNOR CT, DELTONA, FL 32725-5659
(386) 956-5946

Taxonomy

Speciality
Code
Description
License number
State
363LA2100X
Acute Care Nurse Practitioner
Primary
11008378
FL

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
M635630845870
DL NUMBER
FL
Enumeration date
05/26/2021
Last updated
05/26/2021
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