Provider Demographics
NPI:1346993482
Name:HONEYCUTT-MARTIN, ELIZABETH ANN
Entity Type:Individual
Prefix:MRS
First Name:ELIZABETH
Middle Name:ANN
Last Name:HONEYCUTT-MARTIN
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:307 HARBOR APPROACH
Mailing Address - Street 2:
Mailing Address - City:JOHNSON CITY
Mailing Address - State:TN
Mailing Address - Zip Code:37601-3147
Mailing Address - Country:US
Mailing Address - Phone:423-426-6296
Mailing Address - Fax:
Practice Address - Street 1:307 HARBOR APPROACH
Practice Address - Street 2:
Practice Address - City:JOHNSON CITY
Practice Address - State:TN
Practice Address - Zip Code:37601-3147
Practice Address - Country:US
Practice Address - Phone:423-426-6296
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-01-29
Last Update Date:2022-01-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN0000030374163WP2201X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes163WP2201XNursing Service ProvidersRegistered NurseAmbulatory CareGroup - Multi-Specialty