Martin, Ardella Rae
Martin, Ardella Rae is an sole proprietor health care provider with primary practice located at 1632 Busseron St , Vincennes IN 47591-5550. She recently has only one registered license in Other Service Providers / Case Manager/Care Coordinator, which is considered as her primary health care specialty. Martin, Ardella Rae can be contacted via phone (812) 895-0644.Contact Information
Primary practice address
1632 Busseron St
Vincennes IN 47591-5550
Phone: (812) 895-0644
Fax:
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Other Service Providers / Case Manager/Care Coordinator | 171M00000X | PZ0691 | Indiana |
Profile Details
| NPI number | 1316061666 |
|---|---|
| LBN Legal business name | Martin, Ardella Rae |
| Credentials | CASE MANAGER |
| Entity | Individual |
| Sole proprietor 1 | Yes |
| Enumeration date | Mar 19th, 2007 |
| Last updated | Sep 25th, 2008 - about 15 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1316061666 | NPPES |
| Indiana | MEDICAID | 200377980A |
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