Provider Demographics
NPI:1336139153
Name:MARTIN, KAREN LOUISE (FNP)
Entity Type:Individual
Prefix:MRS
First Name:KAREN
Middle Name:LOUISE
Last Name:MARTIN
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 1:1995 HIGHWAY 51 S
Mailing Address - Street 2:SUITE 101
Mailing Address - City:COVINGTON
Mailing Address - State:TN
Mailing Address - Zip Code:38019-3635
Mailing Address - Country:US
Mailing Address - Phone:901-476-7371
Mailing Address - Fax:
Practice Address - Street 1:1995 HIGHWAY 51 S
Practice Address - Street 2:SUITE 101
Practice Address - City:COVINGTON
Practice Address - State:TN
Practice Address - Zip Code:38019-3635
Practice Address - Country:US
Practice Address - Phone:901-476-7371
Practice Address - Fax:901-476-7372
Is Sole Proprietor?:No
Enumeration Date:2005-10-24
Last Update Date:2023-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN7420363LF0000X
KY2707P363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
TN3640634Medicaid
TNMM1243384OtherDEA
TN3640634Medicaid
TNMM1243384OtherDEA