Individual
KELLIE DAVIS MARTINEZ
Active
Individual
KELLIE DAVIS MARTINEZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
FNP
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
0050-02519
NC
363LF0000X
Family Nurse Practitioner
Primary
9700726
NC
Other
Enumeration date
01/31/2007
Last updated
06/26/2020
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