Individual
VALERIE B MARTIN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
240 MAIN STREET, ELLENDALE, ND 58436
(701) 349-3666
(701) 349-4945
Mailing address
PO BOX 1460, ABERDEEN, SD 57402-1460
(605) 622-2876
(605) 622-2804
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
0154
ND
363A00000X
Physician Assistant
0342
SD
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
5301013
—
SD
Enumeration date
11/13/2006
Last updated
02/21/2017
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