Provider Demographics
NPI:1255221404
Name:MARTIN, KIRSTEN LYNNE (ARNP)
Entity type:Individual
Prefix:
First Name:KIRSTEN
Middle Name:LYNNE
Last Name:MARTIN
Suffix:
Gender:F
Credentials:ARNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1322 LAKEVIEW DR
Mailing Address - Street 2:
Mailing Address - City:ELLSTON
Mailing Address - State:IA
Mailing Address - Zip Code:50074-4403
Mailing Address - Country:US
Mailing Address - Phone:641-464-5006
Mailing Address - Fax:
Practice Address - Street 1:800 S FILLMORE ST
Practice Address - Street 2:
Practice Address - City:OSCEOLA
Practice Address - State:IA
Practice Address - Zip Code:50213-1669
Practice Address - Country:US
Practice Address - Phone:641-342-5347
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-07-08
Last Update Date:2025-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IAA185224363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily