Provider Demographics
NPI:1902922073
Name:MARTIN, NANCY CAROLYN (GNP)
Entity Type:Individual
Prefix:MS
First Name:NANCY
Middle Name:CAROLYN
Last Name:MARTIN
Suffix:
Gender:F
Credentials:GNP
Other - Prefix:
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Other - Credentials:
Mailing Address - Street 1:PO BOX 29568
Mailing Address - Street 2:
Mailing Address - City:GREENSBORO
Mailing Address - State:NC
Mailing Address - Zip Code:27429-9568
Mailing Address - Country:US
Mailing Address - Phone:336-273-2511
Mailing Address - Fax:336-370-0287
Practice Address - Street 1:912 THIRD STREET
Practice Address - Street 2:SUITE 101
Practice Address - City:GREENSBORO
Practice Address - State:NC
Practice Address - Zip Code:27405-6967
Practice Address - Country:US
Practice Address - Phone:336-273-2511
Practice Address - Fax:336-370-0287
Is Sole Proprietor?:No
Enumeration Date:2007-03-21
Last Update Date:2010-11-04
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
NC056008363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner