Provider Demographics
NPI:1831660430
Name:MARTIN, JENNIFER ASHER (FNP)
Entity Type:Individual
Prefix:
First Name:JENNIFER
Middle Name:ASHER
Last Name:MARTIN
Suffix:
Gender:F
Credentials:FNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7212 COMMONS CIR
Mailing Address - Street 2:
Mailing Address - City:CHEYENNE
Mailing Address - State:WY
Mailing Address - Zip Code:82009-2667
Mailing Address - Country:US
Mailing Address - Phone:307-635-4141
Mailing Address - Fax:
Practice Address - Street 1:7212 COMMONS CIR
Practice Address - Street 2:
Practice Address - City:CHEYENNE
Practice Address - State:WY
Practice Address - Zip Code:82009-2667
Practice Address - Country:US
Practice Address - Phone:307-635-4141
Practice Address - Fax:307-635-6587
Is Sole Proprietor?:No
Enumeration Date:2018-12-08
Last Update Date:2022-10-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WY24967.1846363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily