Individual
MS. EVELYN TERESA MARTIN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
RN
Contact information
Practice address
309 WABASH AVE, BELLEVILLE, IL 62220-3843
(618) 806-8601
Mailing address
309 WABASH AVE, BELLEVILLE, IL 62220-3843
(618) 806-8601
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
Primary
041178086
IL
163W00000X
Registered Nurse
077284
MO
Other
Enumeration date
08/11/2016
Last updated
08/11/2016
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