Provider Demographics
NPI:1669150058
Name:MARTIN, CATHERINE V
Entity type:Individual
Prefix:
First Name:CATHERINE
Middle Name:V
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 1:3128 GRACELAND CIR
Mailing Address - Street 2:
Mailing Address - City:PINEVILLE
Mailing Address - State:NC
Mailing Address - Zip Code:28134-7480
Mailing Address - Country:US
Mailing Address - Phone:704-605-6435
Mailing Address - Fax:
Practice Address - Street 1:3128 GRACELAND CIR
Practice Address - Street 2:
Practice Address - City:PINEVILLE
Practice Address - State:NC
Practice Address - Zip Code:28134-7480
Practice Address - Country:US
Practice Address - Phone:704-605-6435
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-07-06
Last Update Date:2023-07-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC20150879374J00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374J00000XNursing Service Related ProvidersDoula