Individual
HARRISON MARTIN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
7916 W JEFFERSON BLVD, FORT WAYNE, IN 46804-4140
(260) 969-7280
(260) 458-3461
Mailing address
9321 COVINGTON WOODS CT, FORT WAYNE, IN 46804-7771
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
71013155A
IN
Other
Enumeration date
10/12/2022
Last updated
02/02/2026
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