Individual
MRS. TERESA MCKNIGHT MARTIN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
CRNA
Contact information
Practice address
2460 CURTIS ELLIS DR, ROCKY MOUNT, NC 27804-2298
(252) 443-8015
Mailing address
300 WILDWOOD AVE, ROCKY MOUNT, NC 27803-1728
(252) 977-9200
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
117646
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
8051727
—
NC
Enumeration date
05/11/2007
Last updated
07/08/2007
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