MICAH DESHAUN MARTIN (NPI# 1073002960) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
Nation Provider ID (NPI) | 1073002960 |
Entity Type | Individual |
Full Name | MICAH DESHAUN MARTIN |
Credential | AGNP-C |
Practice Address |
1420 Valwood Pkwy Ste 170 Carrollton TX 75006-8312 |
Mailing Address |
5275 Town and Country Blvd Apt 2448 Frisco TX 75034-6257 |
Practice Telephone | 9188145898 |
Mailing Telephone | 9188145898 |
Enumeration Date | 2018-05-07 |
Last Update Date | 2018-05-07 |
Gender Code | F |
Is Sole Proprietor | N |
Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
---|---|---|---|---|---|
Y | 363LA2200X |
Nurse Practitioner Specialization: Adult Health |
AP136599 | TX | Physician Assistants & Advanced Practice Nursing Providers |
N | 363LG0600X |
Nurse Practitioner Specialization: Gerontology |
AP136599 | TX | Physician Assistants & Advanced Practice Nursing Providers |
Street Address |
1420 VALWOOD PKWY STE 170 |
City | CARROLLTON |
State | TX |
Zip Code | 75006-8312 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1316505043 | Ethicus Hospital Dfw LLC | General Acute Care Hospital | 1401 E. Trinity Mills Road, Carroliton, TX 75006 | 2019-05-29 |
1215422712 | Jennifer Rebecca Joseph | Nurse Anesthetist, Certified Registered | 1446 E Trinity Mills Rd, Carrollton, TX 75006 | 2018-06-27 |
1619479185 | Dedrie Marie Beck | Physical Therapy Assistant | 1000 W. Crosby Road, Carrollton, TX 75006 | 2018-03-01 |
1851892475 | Springcare Enterprises | Clinic/Center | 2840 Keller Springs Road, Suite 601, Carrollton, TX 75006 | 2018-02-28 |
1659892685 | Brandon Maughan | Social Worker | 1100 West Jackson Road, Carrollton, TX 75006 | 2017-06-29 |
1568997500 | Ad Precision Health Clinic, Pllc | Specialist | 2810 E. Trinity Mills Road, Suite 130, Carrollton, TX 75006 | 2017-04-27 |
1366992976 | Total Body Chiropractic | Chiropractor | 2201 Midway Rd Ste 107, Carrollton, TX 75006 | 2016-10-06 |
1679021042 | Keturah Health, LLC | Internal Medicine | 1420 Valwood Parkway, 170a, Carrollton, TX 75006 | 2016-09-14 |
1104202019 | Dazzling Smiles Dental | Dentist | 2145 North Josey Lane., Carrollton, TX 75006 | 2015-08-03 |
1336533595 | First Texas Hospital Carrollton LLC | General Acute Care Hospital | 1401 E. Trinity Mills Rd, Carrollton, TX 75006 | 2015-03-26 |
Find all providers in zip 75006 |
Taxonomy Code | 363LA2200X |
Grouping | Physician Assistants & Advanced Practice Nursing Providers |
Classification | Nurse Practitioner |
Specialization | Adult Health |
Definition to come... |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1053821942 | Shova Gurung | Nurse Practitioner | 3829 Westminster Dr, Carrollton, TX 75007-2628 | 2017-10-04 |
1366452617 | Diana L. Dally | Nurse Practitioner | 1020 Trump Rd, Carrollton, OH 44615 | 2006-08-09 |
1831750926 | Kelli Strickland | Nurse Practitioner | 157 Clinic Ave Ste 201, Carrollton, GA 30117-4454 | 2019-06-28 |
1487153839 | Lauren Holcombe | Nurse Practitioner | 100 Professional Pl Ste 204, Carrollton, GA 30117 | 2018-02-12 |
1881149102 | Shelley Smith | Nurse Practitioner | 129 Bankhead Hwy, Carrollton, GA 30117-3425 | 2016-08-16 |
1952854572 | Hannah Pollard | Nurse Practitioner | 100 Professional Pl, #202, Carrollton, GA 30117-3874 | 2016-07-31 |
1285187161 | Kerri Coduti | Nurse Practitioner | 3730 N Josey Ln, #104, Carrollton, TX 75007-2484 | 2016-07-27 |
1306293923 | Sequoise Givens | Nurse Practitioner | 2459 E Hebron Pkwy, Carrollton, TX 75010-4482 | 2016-05-24 |
1184084600 | Kelly Forrest | Nurse Practitioner | 705 Dixie St, Carrollton, GA 30117-3818 | 2016-02-25 |
1366829095 | Corie Price | Nurse Practitioner | 157 Clinic Ave, Suite 201, Carrollton, GA 30117-4454 | 2015-05-01 |
Find all providers in CARROLLTON |
City | CARROLLTON |
Zip Code | 75006 |
Please comment or provide details below to improve the information on MICAH DESHAUN MARTIN.
Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.