Organization
JULIE K MARTIN, PMHNP-BC, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JULIE MARTIN PMHNP-BC (OWNER/ PROVIDER)
(228) 547-1945
Entity
Organization
Contact information
Practice address
1403 43RD AVE, GULFPORT, MS 39501-2545
(228) 861-5240
Mailing address
1403 43RD AVE, GULFPORT, MS 39501-2545
(228) 547-1945
Taxonomy
Speciality
Code
Description
License number
State
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
02372080
—
MS
Enumeration date
10/05/2018
Last updated
08/18/2020
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