Individual
MRS. JAYNE L MARTIN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CRNP
Contact information
Practice address
3104 STATE ST, ERIE, PA 16508-2820
(814) 226-5500
Mailing address
3104 STATE ST, ERIE, PA 16508-2820
(814) 226-5500
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
RN519930L
PA
363LX0001X
Obstetrics & Gynecology Nurse Practitioner
Primary
VP006257G
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1991407
HIGHMARK
PA
01
—
GR344557
HIGHMARK
PA
01
—
PO0249928
MEDICARE RAILROAD CARRIER
PA
Enumeration date
04/19/2006
Last updated
02/01/2021
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