Individual
LISA NATASHA MARTIN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
APN
Contact information
Practice address
3955 EAGLE CREEK PKWY STE A, INDIANAPOLIS, IN 46254-4692
(317) 410-9978
Mailing address
3145 SUMMERFIELD DR, INDIANAPOLIS, IN 46214-1875
(317) 410-9978
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
28210911A
IN
363LF0000X
Family Nurse Practitioner
Primary
F04180350
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
28210911A
REGISTERED NURSE LICENSE NUMBER
IL
Enumeration date
10/29/2019
Last updated
10/29/2019
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