Organization
COAST NURSE PRACTITIONERS, INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JOHN M MARTIN NP (OWNER)
(228) 826-4600
Entity
Organization
Contact information
Practice address
13300 R.S. KIMBALL ROAD, VANCLEAVE, MS 39565
(228) 826-4600
(228) 826-4600
Mailing address
P.O. BOX 5386, VANCLEAVE, MS 39565
(228) 826-4600
(228) 826-4600
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
—
MS
Other
Enumeration date
01/06/2011
Last updated
01/06/2011
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