Provider Demographics
NPI:1912580648
Name:MARTIN, ALISON JANE
Entity Type:Individual
Prefix:
First Name:ALISON
Middle Name:JANE
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 1:522 BRANDIES CIR STE B2
Mailing Address - Street 2:
Mailing Address - City:MURFREESBORO
Mailing Address - State:TN
Mailing Address - Zip Code:37128-7687
Mailing Address - Country:US
Mailing Address - Phone:615-610-6937
Mailing Address - Fax:
Practice Address - Street 1:522 BRANDIES CIR STE B2
Practice Address - Street 2:
Practice Address - City:MURFREESBORO
Practice Address - State:TN
Practice Address - Zip Code:37128-7687
Practice Address - Country:US
Practice Address - Phone:615-610-6937
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-04-30
Last Update Date:2021-04-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered