Individual
CATHERINE CLARK MARTIN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
APRN
Contact information
Practice address
5306 ROBERTA LN, TAMPA, FL 33617-8722
(813) 370-0754
Mailing address
5306 ROBERTA LN, TAMPA, FL 33617-8722
(813) 370-0754
Taxonomy
Speciality
Code
Description
License number
State
363LA2200X
Adult Health Nurse Practitioner
Primary
11001506
FL
363LG0600X
Gerontology Nurse Practitioner
11001506
FL
363LP2300X
Primary Care Nurse Practitioner
11001506
FL
Other
Enumeration date
02/19/2019
Last updated
11/23/2022
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