Individual
TRACEY MARTIN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
RN
Contact information
Practice address
2104 LEWIS TURNER BLVD, FORT WALTON BEACH, FL 32547-1316
(850) 862-3728
(850) 862-6270
Mailing address
2104 LEWIS TURNER BLVD, FORT WALTON BEACH, FL 32547-1316
(850) 862-3728
(850) 862-6270
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
Primary
RN3205862
FL
Other
Enumeration date
05/03/2012
Last updated
05/03/2012
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