Individual
BREANNA TYLER MARTIN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NP
Contact information
Practice address
1312 E HACKBERRY ST, SALEM, IN 47167-9604
(812) 286-0126
Mailing address
1312 E HACKBERRY ST, SALEM, IN 47167-9604
(812) 286-0126
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
71015633A
IN
Other
Enumeration date
08/16/2024
Last updated
08/16/2024
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