| NPI | 1477222107 |
|---|---|
| Former Name | KRYSTAL NICOLE MARTIN |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LG0600X Nurse Practitioner, Gerontology (Licence: TX 1051896) |
| Additional Taxonomies | 363LA2100X Nurse Practitioner, Acute Care (Licence: TX 1051896) |
| Enumeration Date | 2021-09-07 |
| Last Update Date | 2022-07-15 |