Organization
MARY A MARTIN NP BC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MARY ANN MARTIN NP (PSYCHIATRIC NURSE PRACTITIONER OWNE)
(704) 200-1122
Entity
Organization
Contact information
Practice address
10430 HADDINGTON DR NW, CHARLOTTE, NC 28269-6955
(704) 200-1122
(704) 464-1781
Mailing address
6809 FAIRVIEW RD, CHARLOTTE, NC 28210-4195
(704) 200-1122
(704) 464-1781
Taxonomy
Speciality
Code
Description
License number
State
261QM0850X
Adult Mental Health Clinic/Center
Primary
5002313
NC
Other
Enumeration date
01/20/2017
Last updated
01/20/2017
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