Individual
ELISSA E MARTIN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CNP
Contact information
Practice address
104 DIAMOND DRIVE, ANNA, OH 45302
(937) 394-2900
(937) 394-3602
Mailing address
915 WEST MICHIGAN ST, SIDNEY, OH 45365-2401
(937) 394-2900
(937) 394-3602
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
COA-08452-NP
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
2622782
—
OH
Enumeration date
05/11/2006
Last updated
07/21/2009
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