Individual
JENNY L. MARTIN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
ACNP
Contact information
Practice address
2000 E LAYTON AVE, ST FRANCIS, WI 53235-6053
(414) 744-7880
Mailing address
PO BOX 735044, CHICAGO, IL 60673-5044
(800) 326-2250
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
3955-33
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
10007821
—
WI
01
—
3955-33
LICENSE NUMBER
WI
Enumeration date
02/09/2010
Last updated
02/13/2024
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