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Individual

MRS. MARY ANN MARTIN

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
MHNP

Contact information

Practice address
839 MAJESTIC CT STE 1, GASTONIA, NC 28054-5152
(704) 867-6188
(704) 866-6070
Mailing address
2901 DUBBERLY CT, MATTHEWS, NC 28105-0616
(704) 719-3664
(704) 719-3664

Taxonomy

Speciality
Code
Description
License number
State
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
0050-02313
NC

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
6113022
NC
Enumeration date
12/28/2006
Last updated
07/26/2009
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