Provider Demographics
NPI:1730459132
Name:MARTIN, KATHRYN M (WHNP)
Entity Type:Individual
Prefix:
First Name:KATHRYN
Middle Name:M
Last Name:MARTIN
Suffix:
Gender:F
Credentials:WHNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:700 ACKERMAN RD STE 570
Mailing Address - Street 2:
Mailing Address - City:COLUMBUS
Mailing Address - State:OH
Mailing Address - Zip Code:43202-1579
Mailing Address - Country:US
Mailing Address - Phone:614-293-2391
Mailing Address - Fax:614-293-7443
Practice Address - Street 1:1581 DODD DR
Practice Address - Street 2:4TH FLOOR MCCAMPELL HALL
Practice Address - City:COLUMBUS
Practice Address - State:OH
Practice Address - Zip Code:43210-1257
Practice Address - Country:US
Practice Address - Phone:614-293-0075
Practice Address - Fax:614-293-7031
Is Sole Proprietor?:No
Enumeration Date:2012-01-03
Last Update Date:2012-07-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHRN 138070363LW0102X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LW0102XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerWomen's Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
OHH092880Medicare PIN