Individual
ALYSE C MARTIN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
APRN
Contact information
Practice address
9569 TAYLORSVILLE ROAD SUITE 109, LOUISVILLE, KY 40299
(502) 261-0655
(502) 261-0699
Mailing address
100 E LIBERTY ST SUITE 800, LOUISVILLE, KY 40202-1428
(502) 261-0655
(502) 261-0699
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
3008308
KY
363LF0000X
Family Nurse Practitioner
3008308
KY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
7100261240
—
KY
Enumeration date
09/17/2013
Last updated
12/09/2020
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