Most Relevant Information
Provider Data
| NPI Number: | 1003399866 |
| Provider Name: | JENNIFER R MARTIN RN |
| Entity Type: | Individual |
| Taxonomy Code: | 163WS0200X |
| Specialty: | Registered Nurse |
| License Number: | 36439 |
Most Important Dates
| Enumeration Date: | 09/07/2018 |
| Last Updated: | 09/07/2018 |
Provider Practice Location
1600 SUTTER PL
CLOVIS
NM
881014611
Practice Location Phone/Fax
| Phone: | 5757694490 |
| Fax: | 5757694541 |
Provider Mailing Location
1600 SUTTER PL
CLOVIS
NM
881014611
Provider Mailing Phone/Fax
| Phone: | 5757694490 |
| Fax: | 5757694541 |