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Individual

STACEY N MARTIN

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
NP

Contact information

Practice address
1500 SW 1ST AVE, OCALA, FL 34471-6504
(352) 368-3407
(352) 351-7602
Mailing address
6445 SW 135TH TERRACE RD, OCALA, FL 34481-3489
(352) 465-5417

Taxonomy

Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
RN9202734
FL
363LP0200X
Pediatric Nurse Practitioner
Primary
ARNP9202734
FL

Other

Enumeration date
06/15/2012
Last updated
06/26/2012
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