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Individual

AMANDA GAIL DEAN MARTIN

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
ACNP-BC

Contact information

Practice address
2946 E. BANNER GATEWAY DRIVE, GILBERT, AZ 85234
(480) 256-6444
(480) 256-4734
Mailing address
2940 E BANNER GATEWAY DR, SUITE 450, GILBERT, AZ 85234-2168
(480) 256-6444
(480) 256-4734

Taxonomy

Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
162351
TN
363LA2100X
Acute Care Nurse Practitioner
13770
TN
363LA2100X
Acute Care Nurse Practitioner
Primary
AP4328
AZ

Other

Enumeration date
11/05/2008
Last updated
03/06/2020
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