Individual
MRS. CONNIE SUE MARTEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
APN
Contact information
Practice address
215 W BELLEVILLE ST, NASHVILLE, IL 62263-1448
(618) 316-9423
Mailing address
215 W BELLEVILLE ST, NASHVILLE, IL 62263-1448
(618) 316-9423
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
041.314231
IL
163W00000X
Registered Nurse
2012031563
MO
363L00000X
Nurse Practitioner
209009826
IL
363LF0000X
Family Nurse Practitioner
2012033369
MO
363LF0000X
Family Nurse Practitioner
Primary
209.009826
IL
363LF0000X
Family Nurse Practitioner
209009826
IL
Other
Enumeration date
11/22/2012
Last updated
07/02/2019
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