Individual
MS. STACY D MARTIN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CRNP
Contact information
Practice address
1566 PEA RIDGE RD, SCOTTSVILLE, KY 42164-7702
(928) 266-7022
Mailing address
1566 PEA RIDGE RD, SCOTTSVILLE, KY 42164-7702
(928) 266-7022
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
134146
AZ
363LP0200X
Pediatric Nurse Practitioner
Primary
RN134146
AZ
Other
Enumeration date
05/03/2006
Last updated
01/17/2011
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