Healthcare Provider Details

I. General information

NPI: 1346154945
Provider Name (Legal Business Name): JENNIFER M MARTIN FNP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/30/2026
Last Update Date: 09/30/2026
Certification Date: 09/30/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6276 COUNTY ROAD 107
PROCTORVILLE OH
45669-8867
US

IV. Provider business mailing address

945 GREEN VALLEY RD
HUNTINGTON WV
25701-6245
US

V. Phone/Fax

Practice location:
  • Phone: 740-461-4000
  • Fax:
Mailing address:
  • Phone: 304-521-8450
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License Number0043313
License Number StateOH
# 2
Primary TaxonomyY
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License Number114120
License Number StateWV

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: