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General NPI Number Information
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NPI Number | 1891792172
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Entity Type | Individual
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Provider Name | SUSAN KAY MARTIN APN
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Gender | Female
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Dates
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Enumeration Date | 07/01/2005
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Last Update Date | 03/28/2013
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Provider Practice Location Address
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Address Line | 5201 NORTHSHORE DR
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City | N LITTLE ROCK
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State | AR
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Zip | 72118-5312
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Country | US
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Telephone | 501-748-8000
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Fax | 501-748-8000
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Provider Business Mailing Address
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Address Line | PO BOX 960454
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City | OKLAHOMA CITY
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State | OK
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Zip | 73196-0454
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Country | US
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Telephone | 800-684-0052
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Fax | 405-844-1794
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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 | A01756
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License Number State | AR
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