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General NPI Number Information
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NPI Number | 1073224630
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Entity Type | Individual
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Provider Name | MACOLE JOI MARTIN APRN
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Gender | Female
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Dates
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Enumeration Date | 12/05/2022
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Last Update Date | 01/08/2026
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Provider Practice Location Address
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Address Line | 611 CHURCH ST N
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City | CONCORD
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State | NC
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Zip | 28025-4322
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Country | US
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Telephone | 704-963-9270
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Fax | 704-963-9038
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Provider Business Mailing Address
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Address Line | 611 CHURCH ST N
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City | CONCORD
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State | NC
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Zip | 28025-4322
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Country | US
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Telephone | 704-963-9270
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Fax | 704-963-9038
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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 | 363LP0808X
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Taxonomy Name | Psychiatric/Mental Health Nurse Practitioner
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License Number | 53-81875-062
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License Number State | KS
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Taxonomy #2
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Taxonomy Code | 363LP0808X
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Taxonomy Name | Psychiatric/Mental Health Nurse Practitioner
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License Number | 5023749
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License Number State | NC
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