NPI 1053894998

Jeanette Smith Martin

Practitioner Driver Sunflower, MS

Practice location

Address: 100 Bush Holeman Rd, Sunflower, MS 38778-9789
Phone: (662) 347-6584

Registered specialties

Driver Primary

Other Service Providers Taxonomy 172A00000X Licence 801491923 (MS)

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Registry record

NPI: 1053894998
Entity type: Individual
Sex (as registered): Female
NPI issued: 6 Sep 2018
Record last updated: 6 Sep 2018

Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.