Individual
MRS. KELLY MARIE MARTIN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
CPM, LM
Taxonomy
Speciality
Code
Description
License number
State
176B00000X
Midwife
Primary
1092
MN
374J00000X
Doula
DOULA
MN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
374J00000X
TAXONOMY CODE 374J00000X
MN
Enumeration date
12/25/2009
Last updated
07/21/2022
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