Individual
ALEXA MARTIN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
FNP
Contact information
Practice address
1530 E REPUBLIC RD, SPRINGFIELD, MO 65804-6530
(417) 269-1362
(417) 269-1372
Mailing address
PO BOX 4046, SPRINGFIELD, MO 65808-4046
(417) 269-5712
(417) 269-7567
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
2015014626
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
42002230
—
MO
Enumeration date
06/03/2015
Last updated
12/09/2020
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