Provider Demographics
NPI:1467323105
Name:MARTIN, ABIGAIL GRACE (PA-C)
Entity type:Individual
Prefix:
First Name:ABIGAIL
Middle Name:GRACE
Last Name:MARTIN
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:155 WELLNESS WAY
Mailing Address - Street 2:
Mailing Address - City:STATE COLLEGE
Mailing Address - State:PA
Mailing Address - Zip Code:16803-6702
Mailing Address - Country:US
Mailing Address - Phone:814-278-4851
Mailing Address - Fax:
Practice Address - Street 1:155 WELLNESS WAY
Practice Address - Street 2:
Practice Address - City:STATE COLLEGE
Practice Address - State:PA
Practice Address - Zip Code:16803-6702
Practice Address - Country:US
Practice Address - Phone:814-278-4851
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-09-16
Last Update Date:2025-09-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical