Individual
MRS. CAROLYN B MARTIN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CRNA
Contact information
Practice address
3510 OLD WASHINGTON ROAD, 2ND FLOOR, WALDORF, MD 20602
(240) 427-1731
Mailing address
3510 OLD WASHINGTON ROAD, 2ND FLOOR, WALDORF, MD 20602
(240) 427-1731
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
Primary
R110317
MD
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
R110317
STATE LICENSE
MD
Enumeration date
08/16/2006
Last updated
07/08/2007
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