Provider Demographics
NPI:1497341580
Name:MARTIN, BEVERLY JEAN
Entity Type:Individual
Prefix:
First Name:BEVERLY
Middle Name:JEAN
Last Name: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 1:3413 S LINDEN RD
Mailing Address - Street 2:
Mailing Address - City:FLINT
Mailing Address - State:MI
Mailing Address - Zip Code:48507-3018
Mailing Address - Country:US
Mailing Address - Phone:810-733-5300
Mailing Address - Fax:
Practice Address - Street 1:2545 SPRING ARBOR RD STE 105
Practice Address - Street 2:
Practice Address - City:JACKSON
Practice Address - State:MI
Practice Address - Zip Code:49203-3791
Practice Address - Country:US
Practice Address - Phone:517-783-5853
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-12-14
Last Update Date:2023-06-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes237700000XSpeech, Language and Hearing Service ProvidersHearing Instrument Specialist