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General NPI Number Information
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NPI Number | 1235273368
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Entity Type | Individual
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Provider Name | MARTHA B. KITCHINGS FNP
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Gender | Female
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Dates
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Enumeration Date | 02/20/2007
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Last Update Date | 05/24/2019
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Provider Practice Location Address
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Address Line | 455 S MAIN ST STE 104
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City | HINESVILLE
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State | GA
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Zip | 31313-4354
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Country | US
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Telephone | 912-876-5644
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Fax | 912-408-3457
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Provider Business Mailing Address
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Address Line | PO BOX 919
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City | HINESVILLE
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State | GA
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Zip | 31310-0919
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Country | US
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Telephone | 912-876-5644
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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 | RN022690
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License Number State | GA
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