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Individual

ANDREA SUZANNE MARTIN

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
RN, MSN, FNP-C

Contact information

Practice address
8144 WALNUT HILL LN, SUITE 800, DALLAS, TX 75231-4388
(214) 540-0700
(214) 540-0701
Mailing address
8144 WALNUT HILL LN, SUITE 800, DALLAS, TX 75231-4388
(214) 540-0700
(214) 540-0701

Taxonomy

Speciality
Code
Description
License number
State
363LA2200X
Adult Health Nurse Practitioner
Primary
618452
TX

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
618452
STATE LICENSE
TX
Enumeration date
05/23/2005
Last updated
09/26/2011
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