Individual
JAMIE MARTIN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
500 W BROADWAY ST FL 2, MISSOULA, MT 59802-4008
(406) 728-2539
Mailing address
PO BOX 12, LIBERTY LAKE, WA 99019-0012
(406) 728-2539
(406) 329-5663
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
F07240135
MT
363LF0000X
Family Nurse Practitioner
Primary
NUR-APRN-LIC-241285
MT
390200000X
Student in an Organized Health Care Education/Training Program
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Other
Enumeration date
01/19/2023
Last updated
10/02/2024
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