Kristyn L Martin, NP
Nurse Practitioner in Fruitland, ID. Individual provider (NPI-1).
NPI number1982174199
StatusActive
Last updated in NPPESJan 22, 2019
Details
- NPI
- 1982174199
- Entity type
- Individual (NPI-1)
- Name
- Kristyn L Martin
- Credential
- NP
- Sex
- Female
- Sole proprietor
- No
- Enumeration date
- Nov 30, 2018
- Last updated
- Jan 22, 2019
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 363L00000X | Nurse Practitioner | 60199 | ID | Yes |
| 363L00000X | Nurse Practitioner | 201810671NP-PP | OR |
Other names
- Kristyn L Staal (Former Name)
Practice location
910 Nw 16th St Ste 101Fruitland, ID 83619-2265
Phone 208-452-8000
Mailing address
3340 E Goldstone WayMeridian, ID 83642
Phone 208-452-8000 · Fax 208-452-8055
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