Individual
NICOLE MARTINEZ DE ANDINO
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NP
Contact information
Practice address
1120 15TH ST, AUGUSTA, GA 30912-0004
(706) 724-6100
Mailing address
630 13TH ST STE 250, AUGUSTA, GA 30901-1017
(706) 724-2500
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
RN202000
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
RN202000
GA LICENSE
GA
Enumeration date
09/26/2013
Last updated
05/28/2020
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