Individual
KATHLEEN A. MARTIN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
N.P.
Contact information
Practice address
620 BROAD ST, CENTRAL STATE HOSPITAL, MILLEDGEVILLE, GA 31062-7525
(478) 445-4128
Mailing address
620 BROAD ST, CENTRAL STATE HOSPITAL, MILLEDGEVILLE, GA 31062-7525
(478) 445-4128
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
RN114158NP
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
RN114158NP
LICENSE NUMBER
GA
Enumeration date
06/11/2009
Last updated
06/11/2009
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