Provider Demographics
NPI:1528532108
Name:MARTIN, CHRISTINA RENEE (DNP)
Entity type:Individual
Prefix:MS
First Name:CHRISTINA
Middle Name:RENEE
Last Name:MARTIN
Suffix:
Gender:F
Credentials:DNP
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Mailing Address - Street 1:2825 E BARNETT RD # MSS
Mailing Address - Street 2:
Mailing Address - City:MEDFORD
Mailing Address - State:OR
Mailing Address - Zip Code:97504-8332
Mailing Address - Country:US
Mailing Address - Phone:541-789-4281
Mailing Address - Fax:541-789-4806
Practice Address - Street 1:691 MURPHY RD STE 107
Practice Address - Street 2:
Practice Address - City:MEDFORD
Practice Address - State:OR
Practice Address - Zip Code:97504
Practice Address - Country:US
Practice Address - Phone:541-789-5121
Practice Address - Fax:541-789-5122
Is Sole Proprietor?:No
Enumeration Date:2019-01-16
Last Update Date:2019-11-20
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
UT7003531-4405363LP2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP2300XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPrimary Care
Provider Identifiers
StateIdentifier IDID TypeIssuer
UT7003531-4405OtherAPRN