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Individual

MRS. MARY MARTIN

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
CNS

Contact information

Practice address
85 OLD HUNTSVILLE RD, FAYETTEVILLE, TN 37334-6013
(931) 625-5195
Mailing address
85 OLD HUNTSVILLE RD, FAYETTEVILLE, TN 37334-6013
(931) 625-5195

Taxonomy

Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
1-142250
AL
163W00000X
Registered Nurse
Primary
138544
TN

Other

Enumeration date
08/17/2015
Last updated
08/17/2015
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