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General NPI Number Information
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NPI Number | 1942950050
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Entity Type | Individual
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Provider Name | DAWN PHELPS MARTIN NP
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Gender | Female
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Dates
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Enumeration Date | 03/24/2022
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Last Update Date | 04/05/2022
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Provider Practice Location Address
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Address Line | 800 OAK STREET
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City | FARMVILLE
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State | VA
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Zip | 23901
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Country | US
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Telephone | 434-392-8811
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Fax |
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Provider Business Mailing Address
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Address Line | 2289 SPRING GROVE RD
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City | SPOUT SPRING
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State | VA
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Zip | 24593-2603
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Country | US
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Telephone | 434-610-1497
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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 | 163WE0003X
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Taxonomy Name | Emergency Registered Nurse
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License Number | 0001164576
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License Number State | VA
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Taxonomy #2
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Taxonomy Code | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | 0024184093
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License Number State | VA
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