Kelly Marie Martin, CPM, LM
Individual provider Active NPI Midwife · Elko, MN
NPI 1437489366 · NPPES record last updated Jul 21, 2022
Key facts
- NPI
- 1437489366
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Midwife 176B00000X
- License
- 1092 (MN)
- Practice address
- 26674 Meadow Ridge Dr
Elko, MN 55020-8535 - Phone
- (952) 461-2302
- NPI assigned
- Dec 25, 2009
- 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 |
|---|---|---|---|
| DOULA | MN | MD | Doula |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Doula | 374J00000X | DOULA | MN | |
| Midwife | 176B00000X | 1092 | MN | Yes |
Addresses
Primary practice location
26674 Meadow Ridge Dr
Elko, MN 55020-8535
Mailing address
26674 Meadow Ridge Dr
Elko, MN 55020-8535
Phone (952) 461-2302
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 374J00000X | Other | MN | TAXONOMY CODE 374J00000X |
Other providers in Elko, MN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jul 21, 2022. 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.