Individual
JULIE ALLDREDGE MARTIN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NP, MSN
Contact information
Practice address
8595 PICARDY AVE, STE 100, BATON ROUGE, LA 70809-3670
(225) 763-4900
(225) 763-4928
Mailing address
8490 PICARDY AVE, BLDG 200, BATON ROUGE, LA 70809-3731
(225) 237-1754
(225) 237-1722
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
RN088297-AP05928
LA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
5B116
MEDICARE GROUP PTAN
LA
Enumeration date
08/31/2009
Last updated
06/18/2015
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