Provider Demographics
NPI:1346790003
Name:MARTIN, ALLISON ALEXIS (RN,MSN,WHNP)
Entity type:Individual
Prefix:
First Name:ALLISON
Middle Name:ALEXIS
Last Name:MARTIN
Suffix:
Gender:F
Credentials:RN,MSN,WHNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:300 COMMUNITY DR
Mailing Address - Street 2:
Mailing Address - City:MANHASSET
Mailing Address - State:NY
Mailing Address - Zip Code:11030-3816
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:661 E ALTAMONTE DR STE 318
Practice Address - Street 2:
Practice Address - City:ALTAMONTE SPRINGS
Practice Address - State:FL
Practice Address - Zip Code:32701-5103
Practice Address - Country:US
Practice Address - Phone:407-303-5204
Practice Address - Fax:407-303-5205
Is Sole Proprietor?:Yes
Enumeration Date:2016-10-06
Last Update Date:2023-02-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY420942363LW0102X
FLAPRN11021749363LW0102X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LW0102XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerWomen's Health