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NPI Code Detail

MEDICARE: MRS. JEMIA DARICE MARTIN FNP

MEDICARE: MRS. JEMIA DARICE MARTIN FNP
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1363LF0000XFamily Nurse Practitioner812750NV
2363LF0000XFamily Nurse Practitioner207422OK

General Provider Information

NPI Number : 1023475142
Entity Type Code : Individual
Provider Name (Legal Business Name) : MRS. JEMIA DARICE MARTIN FNP
Provider Business Mailing Address
First Line : PO BOX 740020
Second Line :
City : ATLANTA
State : GA
Zip : 30374-0020
Country : US
Telephone Number : 918-400-7001
Fax Number : 539-202-5070
Provider Business Practice Location Address
First Line : 1538 N LEWIS AVE
Second Line :
City : TULSA
State : OK
Zip : 74110-2535
Country : US
Telephone Number : 918-400-7001
Fax Number : 539-202-5070
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 01/20/2016
Last Update Date : 10/06/2025

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