Individual
MRS. NICKI DAWN MARTIN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
APRN,FNP-BC
Contact information
Practice address
277 GREASY RIDGE RD, PRINCETON, WV 24739-6900
(304) 425-7615
(304) 425-7635
Mailing address
186 ELDER AVE, PRINCETON, WV 24739
(762) 340-9353
(404) 645-7572
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
APRN68714-FNP-BC
WV
363LF0000X
Family Nurse Practitioner
0024172549
VA
363LF0000X
Family Nurse Practitioner
Primary
APRN68714-FNP-BC
WV
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
3810028855
—
WV
Enumeration date
08/21/2014
Last updated
09/20/2024
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