Provider Demographics
NPI:1841662798
Name:MARTIN, EMILY C (NP)
Entity type:Individual
Prefix:
First Name:EMILY
Middle Name:C
Last Name:MARTIN
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1522 CLAREMONT AVE
Mailing Address - Street 2:
Mailing Address - City:ASHLAND
Mailing Address - State:OH
Mailing Address - Zip Code:44805-3533
Mailing Address - Country:US
Mailing Address - Phone:419-207-1085
Mailing Address - Fax:419-207-0607
Practice Address - Street 1:1522 CLAREMONT AVE
Practice Address - Street 2:
Practice Address - City:ASHLAND
Practice Address - State:OH
Practice Address - Zip Code:44805-3533
Practice Address - Country:US
Practice Address - Phone:419-207-1085
Practice Address - Fax:419-207-0607
Is Sole Proprietor?:No
Enumeration Date:2015-10-29
Last Update Date:2016-08-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH399364-1163W00000X
OH17494363LP0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPediatrics
No163W00000XNursing Service ProvidersRegistered Nurse