Martin, Jacquelyn R
Martin, Jacquelyn R is an sole proprietor health care provider with primary practice located at 2651 E Discovery Pkwy , Bloomington IN 47408-9059. She recently has 2 registered licenses in different health care specialties including Physician Assistants & Advanced Practice Nursing Providers / Women's Health, Physician Assistants & Advanced Practice Nursing Providers / Advanced Practice Midwife. Physician Assistants & Advanced Practice Nursing Providers / Advanced Practice Midwife is her primary health care specialty. Martin, Jacquelyn R can be contacted via phone (812) 918-3400.Contact Information
Primary practice address
2651 E Discovery Pkwy
Bloomington IN 47408-9059
Phone: (812) 918-3400
Fax: (812) 918-5829
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Physician Assistants & Advanced Practice Nursing Providers / Women's Health | 363LW0102X | 3015292 | Kentucky |
| Physician Assistants & Advanced Practice Nursing Providers / Advanced Practice Midwife | 367A00000X | COA 07946 NM | Ohio |
| Physician Assistants & Advanced Practice Nursing Providers / Advanced Practice Midwife | 367A00000X | 09000415A | Indiana |
Profile Details
| NPI number | 1942421672 |
|---|---|
| LBN Legal business name | Martin, Jacquelyn R |
| Credentials | Certified Nurse Midwife (CNM) |
| Entity | Individual |
| Sole proprietor 1 | Yes |
| Enumeration date | May 1st, 2007 |
| Last updated | Feb 9th, 2023 - about 2 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 | 1942421672 | NPPES |
| Ohio | Other | 07946 | OHIO LICENSE |
| Ohio | MEDICAID | 300002078 | OHIO LICENSE |
| Ohio | Other | 090540823 | OHIO LICENSE |
| Ohio | MEDICAID | 0099346 | OHIO LICENSE |
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