Individual
AMANDA SMITH MARTINEZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NP
Contact information
Practice address
216 EVANGELINE ST, DERIDDER, LA 70634-4251
(337) 463-4486
Mailing address
216 EVANGELINE ST, DERIDDER, LA 70634-4251
(337) 463-4486
Taxonomy
Speciality
Code
Description
License number
State
363LC1500X
Community Health Nurse Practitioner
Primary
AP10182
LA
Other
Enumeration date
04/10/2019
Last updated
08/24/2023
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