Individual
MICHAEL MARTIN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
FNP-C
Contact information
Practice address
324 N QUEEN ST, KINSTON, NC 28501-4932
(252) 522-9800
Mailing address
6185 JEFFERSON AVE, PARKVILLE, MO 64152
(816) 569-1506
(816) 569-1505
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
2021002927
MO
363LF0000X
Family Nurse Practitioner
Primary
5010050
NC
Other
Enumeration date
11/10/2017
Last updated
03/30/2023
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