Individual
JULIE K MARTIN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PMHNP-BC
Contact information
Practice address
1403 43RD AVE, GULFPORT, MS 39501-2545
(228) 861-5240
Mailing address
1403 43RD AVE, GULFPORT, MS 39501-2545
(228) 861-5240
Taxonomy
Speciality
Code
Description
License number
State
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
901462
MS
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
07152757
—
MS
Enumeration date
09/13/2016
Last updated
08/18/2020
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