Individual
PAMELA MARTIN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CNP
Contact information
Practice address
611 W PARK ST, URBANA, IL 61801-2529
(217) 902-3633
Mailing address
611 W PARK ST, URBANA, IL 61801-2529
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
209020231
IL
Other
Enumeration date
01/10/2022
Last updated
01/10/2022
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