Individual
KARLY MARTIN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
5143 FOREST DR STE 20, COLUMBIA, SC 29206-4918
(803) 314-9120
Mailing address
PO BOX 6069, WEST COLUMBIA, SC 29171-6069
(803) 791-2000
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
27619
SC
390200000X
Student in an Organized Health Care Education/Training Program
245842
SC
Other
Enumeration date
06/12/2023
Last updated
04/17/2024
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