Individual
MARTHA JANE BOOTH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1200 EAST BROAD STREET, WEST HOSPTIAL, 15TH FLOOR, WEST WING, RICHMOND, VA 23298-0645
(804) 628-3215
(804) 827-1016
Mailing address
PO BOX 980645, 1200 EAST BROAD STREET, RICHMOND, VA 23298-0645
Taxonomy
Speciality
Code
Description
License number
State
363LA2100X
Acute Care Nurse Practitioner
Primary
0024172911
VA
Other
Enumeration date
09/23/2015
Last updated
09/23/2015
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