Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 363LA2100X | Nurse Practitioner - Acute Care | 1-141887 | AL |
NPI | 1033723986 |
---|---|
Provider Name | Erin Chrisla Martin |
First Address | Pell City, AL 35125-9314 |
Second Address | Pell City, AL 35125-9314 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 08/09/2020 |
Last Update Date | 08/09/2020 |