Individual
DEREK MARTIN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
CRNA
Contact information
Practice address
333 SMITH AVE N, SAINT PAUL, MN 55102-2344
(651) 241-8000
Mailing address
213 S JEFFERSON ST STE 1006, ROANOKE, VA 24011-1713
(540) 224-5715
(540) 224-5684
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
0024179484
VA
367500000X
Certified Registered Nurse Anesthetist
117227
AR
367500000X
Certified Registered Nurse Anesthetist
AP134368
TX
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
05/01/2017
Last updated
08/12/2022
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