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NPI Code Detail

MEDICARE: KARRIE MARTIN APRN

MEDICARE: KARRIE MARTIN APRN
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1363L00000XNurse Practitioner0024187032VA
2363LF0000XFamily Nurse Practitioner10016905OR
3363LF0000XFamily Nurse Practitioner25338SC
4163WC0400XCase Management Registered Nurse4704303950MI

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1260849OTHERSCRN SC
2F07210180OTHERNP CERTIFICATION
3MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1649624404
Entity Type Code : Individual
Provider Name (Legal Business Name) : KARRIE MARTIN APRN
Provider Business Mailing Address
First Line : 9605 GRAND RONDE RD
Second Line :
City : GRAND RONDE
State : OR
Zip : 97347-9712
Country : US
Telephone Number : 503-879-2060
Fax Number : 503-879-2071
Provider Business Practice Location Address
First Line : 9605 GRAND RONDE RD
Second Line :
City : GRAND RONDE
State : OR
Zip : 97347-9712
Country : US
Telephone Number : 503-879-2060
Fax Number : 503-879-2071
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 04/19/2016
Last Update Date : 02/10/2026

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Directions to “ KARRIE MARTIN APRN” Practice Location

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