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General NPI Number Information
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NPI Number | 1063548444
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Entity Type | Individual
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Provider Name | CATHY A MARTIN RN 047911
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Gender | Female
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Dates
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Enumeration Date | 02/27/2007
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | 114 FOREST AVENUE
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City | MACON
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State | GA
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Zip | 31032
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Country | US
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Telephone | 478-986-3164
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Fax | 478-986-3339
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Provider Business Mailing Address
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Address Line | 811 HEMLOCK ST
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City | MACON
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State | GA
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Zip | 31201-2144
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Country | US
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Telephone | 478-751-6119
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Fax | 478-751-6099
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 163W00000X
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Taxonomy Name | Registered Nurse
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License Number | RN 047911
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License Number State | GA
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