Individual
MRS. KARLY IRENE MARTIN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LPN
Contact information
Practice address
14772 W HIDDEN CREEK CT, NEW BERLIN, WI 53151-4441
(414) 640-0840
Mailing address
14772 W HIDDEN CREEK CT, NEW BERLIN, WI 53151-4441
(414) 640-0840
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
311424-031
WI
Other
Enumeration date
08/07/2009
Last updated
08/07/2009
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