Search › Illinois › 363LA2100X
Samantha Martin, AGACNP-BC
NPI 1396314308 · on the registry since 2021
Practice
- Address
- Address: 530 Ne Glen Oak Ave
Peoria, IL 61637 - Phone
- (309) 655-2000
Registry record
- Primary taxonomy
- 363LA2100X
363LA2100X
- Also registered as
- 363LG0600X
- Licence states on file
- IL
From the registry's licence fields, which are often incomplete.
- Sex
- Female
- Record last updated
- 2021-06-23
Source: CMS National Plan and Provider Enumeration System. Registration is not the same as practising, and the registry records no retirement — some people listed here no longer practise. More in Illinois