Provider Demographics
NPI:1114600939
Name:MARTIN, NATALIE ELISABETH (APRN)
Entity Type:Individual
Prefix:
First Name:NATALIE
Middle Name:ELISABETH
Last Name:MARTIN
Suffix:
Gender:F
Credentials:APRN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6 FIELDSTONE DR
Mailing Address - Street 2:
Mailing Address - City:NEWTOWN
Mailing Address - State:CT
Mailing Address - Zip Code:06470-2422
Mailing Address - Country:US
Mailing Address - Phone:203-648-1418
Mailing Address - Fax:
Practice Address - Street 1:6 FIELDSTONE DR
Practice Address - Street 2:
Practice Address - City:NEWTOWN
Practice Address - State:CT
Practice Address - Zip Code:06470-2422
Practice Address - Country:US
Practice Address - Phone:203-648-1418
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-08-09
Last Update Date:2023-08-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT12223363LA2200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health