Individual
GINA MARTIN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CRNP
Contact information
Practice address
1500 DIXON ST #202, FREDERICKSBURG, VA 22401
(540) 370-0430
(540) 370-0021
Mailing address
1500 DIXON ST #202, FREDERICKSBURG, VA 22401
(540) 370-0430
(540) 370-0021
Taxonomy
Speciality
Code
Description
License number
State
363LA2200X
Adult Health Nurse Practitioner
Primary
0024164764
VA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0087
CAREFIRST BC OF NCA NUMBE
DC
05
—
010064741
—
VA
05
—
040593900
—
MD
01
—
64135601
CAREFIRST BC OF MD
MD
Enumeration date
03/09/2006
Last updated
09/17/2012
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