Individual
CAROL ENNIS MARTIN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
APRN
Contact information
Practice address
THE KENTUCKY CLINIC WING D J252, 740 S. LIMESTONE, LEXINGTON, KY 40536
(859) 323-2089
(859) 218-7487
Mailing address
740 S. LIMESTONE, THE KENTUCKY CLINIC WING D - J252, LEXINGTON, KY 40536-0284
(859) 218-0362
(859) 257-5013
Taxonomy
Speciality
Code
Description
License number
State
363LP0200X
Pediatric Nurse Practitioner
Primary
3002688
KY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
78026887
—
KY
Enumeration date
02/05/2007
Last updated
09/08/2018
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