Martin, Kathleen A.

Martin, Kathleen A. is an individual health care provider with primary practice located at 520 S Eagle Rd Suite 3209, Meridian ID 83642-6351. She recently has only one registered license in Physician Assistants & Advanced Practice Nursing Providers / Obstetrics & Gynecology, which is considered as her primary health care specialty. Martin, Kathleen A. can be contacted via phone (208) 884-3980.

Contact Information

Primary practice address
520 S Eagle Rd Suite 3209 Meridian ID 83642-6351
Phone: (208) 884-3980
Fax: (208) 884-3979
Website:
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Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Obstetrics & Gynecology 363LX0001X NP88A Idaho

Profile Details

NPI number 1164441143
LBN Legal business name Martin, Kathleen A.
Credentials Nurse Practitioner (NP)
Entity Individual
Sole proprietor 1 No
Enumeration date Jul 19th, 2006
Last updated Nov 10th, 2012 - about 12 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1164441143 NPPES
Idaho Other 781786 DESERET
Idaho Other 500029223 DESERET
Idaho Other 820367722C012 DESERET
Idaho Other NPNB1 DESERET
Idaho Other 820367722A010 DESERET
Idaho Other 000010016728 DESERET
Idaho Other 000010016729 DESERET
Idaho MEDICAID 805800900 DESERET

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