Individual
KAY DAWN MARTENS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
FNP-C, PMHNP-BC
Contact information
Practice address
334 E 200 S, BURLEY, ID 83318-5433
(208) 260-0961
Mailing address
334 E 200 S, BURLEY, ID 83318-5433
(208) 260-0961
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
63267
ID
Other
Enumeration date
01/03/2020
Last updated
06/22/2021
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