Individual
MELISSA DIANE MARTIN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
928 W COMMERCE ST, SAN ANTONIO, TX 78207-4444
(210) 261-1250
Mailing address
10050 GREAT HILLS TRL, #1213, AUSTIN, TX 78759-5938
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
TAP8335
AZ
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
AP130804
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
TAP8335
AZ STATE BOARD OF NURSING - TYPE: TEMPORARY ADVANCED PRACTITIONER -SPECIALTY:FNP
AZ
Enumeration date
12/31/2015
Last updated
10/18/2021
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