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General NPI Number Information
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NPI Number | 1578738076
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Entity Type | Individual
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Provider Name | EVELYN M. MARTIN DNP, APRN, FNP-BC
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Gender | Female
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Dates
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Enumeration Date | 04/25/2008
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Last Update Date | 02/17/2022
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Provider Practice Location Address
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Address Line | 3110 MACCORKLE AVE SE ROOM 2016
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City | CHARLESTON
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State | WV
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Zip | 25304-1210
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Country | US
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Telephone | 304-347-1345
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Fax | 304-347-1346
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Provider Business Mailing Address
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Address Line | 7 BETTE LN
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City | HURRICANE
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State | WV
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Zip | 25526-9722
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Country | US
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Telephone | 304-757-4819
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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 | APRN64549-FNP-BC
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License Number State | WV
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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 | SP025002
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License Number State | PA
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