Provider Demographics
NPI:1740717677
Name:MARTIN, JENNIFER CATHERINE (MD)
Entity type:Individual
Prefix:
First Name:JENNIFER
Middle Name:CATHERINE
Last Name:MARTIN
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:JENNIFER
Other - Middle Name:CATHERINE
Other - Last Name:NERGARD
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:1195 OLD HICKORY BLVD STE 200
Mailing Address - Street 2:
Mailing Address - City:BRENTWOOD
Mailing Address - State:TN
Mailing Address - Zip Code:37027-4239
Mailing Address - Country:US
Mailing Address - Phone:615-835-3220
Mailing Address - Fax:615-835-3235
Practice Address - Street 1:1195 OLD HICKORY BLVD STE 202
Practice Address - Street 2:
Practice Address - City:BRENTWOOD
Practice Address - State:TN
Practice Address - Zip Code:37027-4239
Practice Address - Country:US
Practice Address - Phone:615-835-3220
Practice Address - Fax:615-835-3235
Is Sole Proprietor?:Yes
Enumeration Date:2017-05-23
Last Update Date:2025-11-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN75067207N00000X
TXBP10060357207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207N00000XAllopathic & Osteopathic PhysiciansDermatologyGroup - Single Specialty
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine