Provider Demographics
NPI:1275214058
Name:MARTIN, NATALIE JANE (APRN, CNM)
Entity Type:Individual
Prefix:
First Name:NATALIE
Middle Name:JANE
Last Name:MARTIN
Suffix:
Gender:F
Credentials:APRN, CNM
Other - Prefix:
Other - First Name:NATALIE
Other - Middle Name:JANE
Other - Last Name:KEATON
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:211 JAYBIRD LN
Mailing Address - Street 2:
Mailing Address - City:SOUTH SHORE
Mailing Address - State:KY
Mailing Address - Zip Code:41175-7028
Mailing Address - Country:US
Mailing Address - Phone:606-465-6970
Mailing Address - Fax:
Practice Address - Street 1:617 23RD ST STE 415
Practice Address - Street 2:
Practice Address - City:ASHLAND
Practice Address - State:KY
Practice Address - Zip Code:41101-2882
Practice Address - Country:US
Practice Address - Phone:606-325-6888
Practice Address - Fax:606-326-9368
Is Sole Proprietor?:No
Enumeration Date:2023-07-26
Last Update Date:2023-09-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY4007441367A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367A00000XPhysician Assistants & Advanced Practice Nursing ProvidersAdvanced Practice Midwife