Individual
ANNE T MARTIN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NP
Contact information
Practice address
11725 N ILLINOIS ST, SUITE 465, CARMEL, IN 46032-3010
(317) 817-0010
(317) 817-0012
Mailing address
250 N SHADELAND AVE, STE 130 PROVIDER ENROLLMENT, INDIANAPOLIS, IN 46219-4959
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
28139087A
IN
363LA2100X
Acute Care Nurse Practitioner
Primary
71002731
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
201146210
—
IN
Enumeration date
09/03/2008
Last updated
02/10/2014
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