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General NPI Number Information
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NPI Number | 1871543108
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Entity Type | Individual
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Provider Name | MINDY TEANN MARTIN ARNP
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Gender | Female
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Dates
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Enumeration Date | 05/10/2006
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Last Update Date | 01/25/2013
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Provider Practice Location Address
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Address Line | 1951 51ST ST NE
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City | CEDAR RAPIDS
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State | IA
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Zip | 52402-2460
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Country | US
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Telephone | 319-294-1899
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Fax | 319-294-1773
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Provider Business Mailing Address
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Address Line | 1951 51ST ST NE
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City | CEDAR RAPIDS
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State | IA
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Zip | 52402-2460
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Country | US
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Telephone | 319-294-1899
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Fax | 319-294-1773
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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 | 363LA2200X
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Taxonomy Name | Adult Health Nurse Practitioner
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License Number | A095901
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License Number State | IA
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