Individual
MARIA RAVKATOVNA MARTIN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
1201 GRANT BLVD, ST LOUIS, MO 63104
(314) 257-8000
Mailing address
539 N. WESTORER BLVD, AP 4101, ALBANY, GA 31707
(229) 854-4670
Taxonomy
Speciality
Code
Description
License number
State
363LA2100X
Acute Care Nurse Practitioner
Primary
RN252454
GA
Other
Enumeration date
09/23/2022
Last updated
09/23/2022
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