Individual
KOURTNEY MARTIN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CNM
Contact information
Practice address
1560 KINGSLEY AVE STE 4, ORANGE PARK, FL 32073-9200
(904) 264-1628
Mailing address
197 N LAKE CUNNINGHAM AVE, JACKSONVILLE, FL 32259-7939
Taxonomy
Speciality
Code
Description
License number
State
176B00000X
Midwife
11015562
FL
367A00000X
Advanced Practice Midwife
Primary
11015562
FL
367A00000X
Advanced Practice Midwife
4010884
KY
Other
Enumeration date
09/23/2021
Last updated
12/21/2023
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