Susan Kay Martin, APN
Individual provider Active NPI Family Nurse Practitioner · N Little Rock, AR
NPI 1891792172 · NPPES record last updated Mar 28, 2013
Key facts
- NPI
- 1891792172
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Family Nurse Practitioner 363LF0000X
- License
- A01756 (AR)
- Practice address
- 5201 Northshore Dr
N Little Rock, AR 72118-5312 - Phone
- (501) 748-8000
- Fax
- (501) 748-8000
- NPI assigned
- Jul 1, 2005
- Sex
- Female
- Sole proprietor
- No
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Nurse Practitioner
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 1106 | AR | MD | Speech-Language Pathologist |
| A01756 | AR | MD | Family Nurse Practitioner |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Nurse Practitioner | 363LF0000X | A01756 | AR | Yes |
Addresses
Primary practice location
5201 Northshore Dr
N Little Rock, AR 72118-5312
Mailing address
PO Box 960454
Oklahoma City, OK 73196-0454
Phone (800) 684-0052
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 157708758 | Medicaid | AR | |
| P00218372 | Other | RAILROAD MEDICARE | |
| P01121769 | Other | AR | RAILROAD MEDICARE |
Other providers in N Little Rock, AR
- Kroger Limited Partnership I
- Kroger Limited Partnership I
- Jordan Lancaster
- Govinda Prasad Lohani
- Lyndro Enterprises LLC
- Mary Medical Equipment and Supplies LLC
- Chad D Matone
- Mircia Matos
- Julia M McCoy
- Annette P Meador
All providers in N Little Rock, AR · Family Nurse Practitioner in Arkansas
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Mar 28, 2013. 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.