Provider Demographics
NPI:1235246554
Name:MARTINSON, KATHRYN L (MSN FNP-BC ARNP)
Entity Type:Individual
Prefix:MS
First Name:KATHRYN
Middle Name:L
Last Name:MARTINSON
Suffix:
Gender:F
Credentials:MSN FNP-BC ARNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:717 GIVENS LN
Mailing Address - Street 2:
Mailing Address - City:BLACKSBURG
Mailing Address - State:VA
Mailing Address - Zip Code:24060-1834
Mailing Address - Country:US
Mailing Address - Phone:540-951-0790
Mailing Address - Fax:540-951-0790
Practice Address - Street 1:550 N FRANKLIN ST
Practice Address - Street 2:MINUTECLINIC
Practice Address - City:CHRISTIANSBURG
Practice Address - State:VA
Practice Address - Zip Code:24073-1916
Practice Address - Country:US
Practice Address - Phone:540-381-1153
Practice Address - Fax:540-381-1153
Is Sole Proprietor?:No
Enumeration Date:2006-08-23
Last Update Date:2013-07-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0024167407363L00000X, 363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL300647600Medicaid
VA015448N34Medicare PIN
FL300647600Medicaid