Provider Demographics
NPI:1336299890
Name:MARTIN, JOYCE M (NP)
Entity Type:Individual
Prefix:
First Name:JOYCE
Middle Name:M
Last Name:MARTIN
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:1040 CRANSTON ST
Mailing Address - Street 2:
Mailing Address - City:CRANSTON
Mailing Address - State:RI
Mailing Address - Zip Code:02920-7535
Mailing Address - Country:US
Mailing Address - Phone:401-942-0600
Mailing Address - Fax:401-943-0604
Practice Address - Street 1:1040 CRANSTON STREET
Practice Address - Street 2:
Practice Address - City:CRANSTON
Practice Address - State:RI
Practice Address - Zip Code:02920
Practice Address - Country:US
Practice Address - Phone:401-942-0600
Practice Address - Fax:401-943-0604
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-10
Last Update Date:2023-11-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT8390363L00000X
RIDCP00362111NR0400X
MARN243505363LF0000X
RI01338363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
No111NR0400XChiropractic ProvidersChiropractorRehabilitation
No363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
RIU63117Medicare UPIN