Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 363LN0005X | Nurse Practitioner - Neonatal (Critical Care) | AP137152 | TX |
Y | 363LN0005X | Nurse Practitioner - Neonatal (Critical Care) | RN129363 | TN |
NPI | 1023394046 |
---|---|
Provider Name | Christina M Martin |
First Address | Dallas, TX 75235-7701 |
Second Address | Dallas, TX 75235 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 24/10/2011 |
Last Update Date | 30/10/2020 |