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General NPI Number Information
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NPI Number | 1740114545
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Entity Type | Individual
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Provider Name | JENNETTE MARTIN RN
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Gender | Female
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Dates
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Enumeration Date | 06/09/2026
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Last Update Date | 06/09/2026
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Provider Practice Location Address
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Address Line | 2919 STURGIS RD
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City | ROCK HILL
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State | SC
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Zip | 29730-6673
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Country | US
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Telephone | 839-388-5581
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Fax |
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Provider Business Mailing Address
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Address Line | 1238 LITTLE ROY LN
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City | CATAWBA
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State | SC
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Zip | 29704-7779
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Country | US
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Telephone | 843-957-9575
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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 | 163WP0808X
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Taxonomy Name | Psychiatric/Mental Health Registered Nurse
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License Number | 218292
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License Number State | SC
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