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General NPI Number Information
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NPI Number | 1851926968
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Entity Type | Individual
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Provider Name | GINGER MARTIN FNP
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Gender | Female
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Dates
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Enumeration Date | 03/09/2020
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Last Update Date | 03/09/2020
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Provider Practice Location Address
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Address Line | 3326 FRONT ST STE C
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City | WINNSBORO
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State | LA
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Zip | 71295-6418
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Country | US
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Telephone | 318-367-6060
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Fax |
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Provider Business Mailing Address
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Address Line | 149 PAULA DR UNIT 1
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City | WEST MONROE
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State | LA
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Zip | 71291-7529
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Country | US
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Telephone |
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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 | F02180767
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License Number State | LA
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