Individual
MRS. CARA DAWN MARTIN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
FNP-C
Contact information
Practice address
MEDICAL CENTER BLVD, WINSTON SALEM, NC 27157-0001
(336) 716-2580
Mailing address
MEDICAL CENTER BLVD, WINSTON SALEM, NC 27157-0001
(336) 716-2580
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
5012201
NC
363LF0000X
Family Nurse Practitioner
5012201
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
5012201
NP LICENSE
NC
Enumeration date
09/03/2019
Last updated
08/27/2020
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