Provider Demographics
NPI:1144634999
Name:MARTIN, DANIELLE PAIGE (NP-C)
Entity type:Individual
Prefix:MRS
First Name:DANIELLE
Middle Name:PAIGE
Last Name:MARTIN
Suffix:
Gender:F
Credentials:NP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:165 EMERY HWY.
Mailing Address - Street 2:SUITE #100
Mailing Address - City:MACON
Mailing Address - State:GA
Mailing Address - Zip Code:31217
Mailing Address - Country:US
Mailing Address - Phone:478-741-2150
Mailing Address - Fax:478-741-2208
Practice Address - Street 1:2400 BELLEVUE RD.
Practice Address - Street 2:SUITE# 29-B
Practice Address - City:DUBLIN
Practice Address - State:GA
Practice Address - Zip Code:31021
Practice Address - Country:US
Practice Address - Phone:478-741-2150
Practice Address - Fax:478-741-2208
Is Sole Proprietor?:No
Enumeration Date:2014-06-19
Last Update Date:2014-06-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program