Provider Demographics
NPI:1164245445
Name:MARTIN, KRISTINE LOUISE (APRN-CNP)
Entity type:Individual
Prefix:MRS
First Name:KRISTINE
Middle Name:LOUISE
Last Name:MARTIN
Suffix:
Gender:F
Credentials:APRN-CNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
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Other - Credentials:
Mailing Address - Street 1:113 3RD AVE NE
Mailing Address - Street 2:
Mailing Address - City:MAYVILLE
Mailing Address - State:ND
Mailing Address - Zip Code:58257-1220
Mailing Address - Country:US
Mailing Address - Phone:701-430-3429
Mailing Address - Fax:
Practice Address - Street 1:107 12TH ST S
Practice Address - Street 2:
Practice Address - City:COOPERSTOWN
Practice Address - State:ND
Practice Address - Zip Code:58425-4501
Practice Address - Country:US
Practice Address - Phone:701-786-1700
Practice Address - Fax:701-786-7122
Is Sole Proprietor?:No
Enumeration Date:2024-11-05
Last Update Date:2025-05-14
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
ND201116363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily