Individual provider · Type 1 NPI

Mia Carroll Martin, RN, CPNP

Pediatric Nurse Practitioner · Dallas, TX

NPI number 1508104001 Active

Practice location

1935 Medical District Dr, Children's Medical Center
Dallas, TX 75235-7701

Specialties and licenses

Taxonomy	Code	License
Pediatric Nurse Practitioner Primary	363LP0200X	720959 (TX)

Pediatric Nurse Practitioner: Definition to come...

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About NPI 1508104001

Mia Carroll Martin, RN, CPNP's National Provider Identifier is 1508104001, issued on Jan 18, 2013. The primary taxonomy on file is Pediatric Nurse Practitioner (363LP0200X), and the practice location is in Dallas, TX. The record was last updated on Aug 20, 2020.