Michelle Elaine Martin, LPN
Individual provider Active NPI Licensed Practical Nurse · Deerfield, WI
NPI 1295495802 · NPPES record last updated Dec 22, 2021
Key facts
- NPI
- 1295495802
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Licensed Practical Nurse 164W00000X
- License
- 301758 (WI)
- Practice address
- 1515 Hommen Rd
Deerfield, WI 53531-9678 - Phone
- (608) 444-0774
- NPI assigned
- Dec 22, 2021
- Sex
- Female
- Sole proprietor
- Yes
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 301758 | WI | MD | Licensed Practical Nurse |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Licensed Practical Nurse | 164W00000X | 301758 | WI | Yes |
Addresses
Primary practice location
1515 Hommen Rd
Deerfield, WI 53531-9678
Mailing address
175 Waterloo St
Columbus, WI 53925-1764
Phone (608) 695-0594
Other providers in Deerfield, WI
- Belinda Sue Huber
- Kristen Lynn Kroll
- Christine L Lange
- Lacy Loudon
- Mabie Pharmacy, LLC
- Stephanie Nanstad
- New Life Medical Transport & Delivery
- Annette Plante
- Mary Preysz
- Diana Regoli
All providers in Deerfield, WI · Licensed Practical Nurse in Wisconsin
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Dec 22, 2021. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.