| NPI | 1033591656 | 
|---|---|
| Former Name | REBECCA M MARTIN | 
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: NC 5015553) | 
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: WV 64562) | 
| Enumeration Date | 2015-06-19 | 
| Last Update Date | 2024-03-22 |