Individual
MARY MALLORY MARTIN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CRNP
Contact information
Practice address
3400 HIGHWAY 78 E STE 412, JASPER, AL 35501-8952
(205) 384-3013
(205) 384-3078
Mailing address
3400 HIGHWAY 78 EAST, SUITE 412, JASPER, AL 35501-4718
(205) 384-3013
(205) 384-3078
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
1-137813
AL
363LF0000X
Family Nurse Practitioner
1-137813
AL
Other
Enumeration date
07/05/2017
Last updated
09/12/2024
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