Provider Demographics
NPI:1235273368
Name:KITCHINGS, MARTHA B (FNP)
Entity Type:Individual
Prefix:MS
First Name:MARTHA
Middle Name:B
Last Name:KITCHINGS
Suffix:
Gender:F
Credentials:FNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 919
Mailing Address - Street 2:
Mailing Address - City:HINESVILLE
Mailing Address - State:GA
Mailing Address - Zip Code:31310-0919
Mailing Address - Country:US
Mailing Address - Phone:912-876-5644
Mailing Address - Fax:
Practice Address - Street 1:455 S MAIN ST STE 104
Practice Address - Street 2:
Practice Address - City:HINESVILLE
Practice Address - State:GA
Practice Address - Zip Code:31313-4354
Practice Address - Country:US
Practice Address - Phone:912-876-5644
Practice Address - Fax:912-408-3457
Is Sole Proprietor?:No
Enumeration Date:2007-02-20
Last Update Date:2019-05-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GARN022690363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
GA000764629BMedicaid
GA000764629CMedicaid