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General NPI Number Information
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NPI Number | 1063592749
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Entity Type | Individual
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Provider Name | CRISTINA MICHELLE MARTIN RN, MSN, FNP-C
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Gender | Female
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Dates
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Enumeration Date | 10/16/2006
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | 3350 MCFADDIN #2
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City | BEAUMONT
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State | TX
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Zip | 77706
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Country | US
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Telephone | 409-833-0342
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Fax |
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Provider Business Mailing Address
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Address Line | 595 N 23RD ST
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City | BEAUMONT
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State | TX
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Zip | 77706-4935
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Country | US
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Telephone | 409-924-7849
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Fax |
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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 | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | 609082
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License Number State | TX
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