Individual
LISA KAY MARTIN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CNA
Taxonomy
Speciality
Code
Description
License number
State
376K00000X
Nurse's Aide
Primary
CNA205750
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
$$$$$$$$$
SOCIAL SECURITY ACT MEDICARE
FL
01
—
W1156 65679
AETNA NAP KRAFT FOODS GRP 469670-27-103
FL
Enumeration date
05/20/2013
Last updated
05/21/2020
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