Provider Demographics
NPI:1255917860
Name:MARTIN, NANCY E (RPH)
Entity type:Individual
Prefix:
First Name:NANCY
Middle Name:E
Last Name:MARTIN
Suffix:
Gender:F
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:89 TRAMMELL BLOCK
Mailing Address - Street 2:
Mailing Address - City:VALLEY
Mailing Address - State:AL
Mailing Address - Zip Code:36854
Mailing Address - Country:US
Mailing Address - Phone:334-756-2305
Mailing Address - Fax:
Practice Address - Street 1:89 TRAMMELL BLOCK
Practice Address - Street 2:
Practice Address - City:VALLEY
Practice Address - State:AL
Practice Address - Zip Code:36854
Practice Address - Country:US
Practice Address - Phone:334-756-2305
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-03-23
Last Update Date:2021-03-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL9533183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist