Provider Demographics
NPI:1538290283
Name:POLLETT, MARTHA SARAH (LPN)
Entity Type:Individual
Prefix:MRS
First Name:MARTHA
Middle Name:SARAH
Last Name:POLLETT
Suffix:
Gender:F
Credentials:LPN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1651 FARBERDALE DR
Mailing Address - Street 2:
Mailing Address - City:COLUMBUS
Mailing Address - State:OH
Mailing Address - Zip Code:43223-3383
Mailing Address - Country:US
Mailing Address - Phone:614-274-6098
Mailing Address - Fax:
Practice Address - Street 1:1651 FARBERDALE DR
Practice Address - Street 2:
Practice Address - City:COLUMBUS
Practice Address - State:OH
Practice Address - Zip Code:43223-3383
Practice Address - Country:US
Practice Address - Phone:614-274-6098
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-07
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHPN121838164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse