Individual
MRS. CHRISTELE KIDIBU MARTIN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
FNP-BC
Contact information
Practice address
2101 PETERS CREEK PKWY STE 16-19, WINSTON SALEM, NC 27127-3726
(336) 955-1379
(336) 893-9987
Mailing address
PO BOX 12341, WINSTON SALEM, NC 27117-2341
(336) 955-1379
Taxonomy
Speciality
Code
Description
License number
State
207QA0505X
Adult Medicine Physician
2023085235
NC
363LF0000X
Family Nurse Practitioner
Primary
5019140
NC
Other
Enumeration date
11/06/2023
Last updated
06/11/2026
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