Individual
MRS. MARILYN LOUISE MARTIN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RN
Contact information
Practice address
23636 S 204TH ST, QUEEN CREEK, AZ 85242-9677
(480) 987-5920
Mailing address
4417 E PONY TRACK LN, QUEEN CREEK, AZ 85242-8289
(480) 655-5844
Taxonomy
Speciality
Code
Description
License number
State
163WS0200X
School Registered Nurse
Primary
RN055067
AZ
Other
Enumeration date
10/19/2006
Last updated
07/08/2007
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