Individual
SHALETHA MARTIN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NP
Contact information
Practice address
11273 HIGHWAY 61 N, ROBINSONVILLE, MS 38664-9705
(662) 363-3224
(662) 363-3234
Mailing address
2135 HENRY HILL DR, JACKSON, MS 39204-2006
(601) 398-2335
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
904818
MS
Other
Enumeration date
08/13/2021
Last updated
09/19/2022
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