Provider Demographics
NPI:1841814530
Name:MARTIN, JAMIE ELIZABETH (CNM)
Entity type:Individual
Prefix:
First Name:JAMIE
Middle Name:ELIZABETH
Last Name:MARTIN
Suffix:
Gender:F
Credentials:CNM
Other - Prefix:
Other - First Name:JAMIE
Other - Middle Name:ELIZABETH
Other - Last Name:WALTON
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:781 AVENT FERRY RD STE 214
Mailing Address - Street 2:
Mailing Address - City:HOLLY SPRINGS
Mailing Address - State:NC
Mailing Address - Zip Code:27540-7776
Mailing Address - Country:US
Mailing Address - Phone:919-567-6133
Mailing Address - Fax:
Practice Address - Street 1:781 AVENT FERRY RD STE 214
Practice Address - Street 2:
Practice Address - City:HOLLY SPRINGS
Practice Address - State:NC
Practice Address - Zip Code:27540-7776
Practice Address - Country:US
Practice Address - Phone:919-567-6133
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-05-29
Last Update Date:2022-11-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0024178824367A00000X
MDR238425367A00000X
NC774367A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367A00000XPhysician Assistants & Advanced Practice Nursing ProvidersAdvanced Practice Midwife