Most Relevant Information
Provider Data
| NPI Number: | 1003286881 |
| Provider Name: | REBECCA MARTIN |
| Entity Type: | Individual |
| Taxonomy Code: | 363LF0000X |
| Specialty: | Nurse Practitioner |
| License Number: | F340055 |
Most Important Dates
| Enumeration Date: | 10/06/2015 |
| Last Updated: | 05/13/2016 |
Provider Practice Location
112 KIMBALL AVE
PENN YAN
NY
145271816
Practice Location Phone/Fax
| Phone: | 3155319102 |
| Fax: | 3155319103 |
Provider Mailing Location
PO BOX 423
14 MAIDEN LANE
PENN YAN
NY
145270423
Provider Mailing Phone/Fax
| Phone: | 3155319102 |
| Fax: | 3155319103 |