Provider Demographics
NPI:1871077511
Name:MARTIN, JANET REEVES (APRN)
Entity type:Individual
Prefix:
First Name:JANET
Middle Name:REEVES
Last Name:MARTIN
Suffix:
Gender:F
Credentials:APRN
Other - Prefix:
Other - First Name:JANET
Other - Middle Name:LEE
Other - Last Name:MARTIN
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:APRN
Mailing Address - Street 1:130 PAVILLON DR.
Mailing Address - Street 2:
Mailing Address - City:NEWPORT, KY
Mailing Address - State:OH
Mailing Address - Zip Code:41071
Mailing Address - Country:US
Mailing Address - Phone:859-652-7203
Mailing Address - Fax:
Practice Address - Street 1:INFINITY DIALYSIS
Practice Address - Street 2:4750 EAST GALBRAITH RD. SUITE 103
Practice Address - City:CINCINNATI
Practice Address - State:OH
Practice Address - Zip Code:41017
Practice Address - Country:US
Practice Address - Phone:513-984-3500
Practice Address - Fax:513-791-2151
Is Sole Proprietor?:Yes
Enumeration Date:2018-09-19
Last Update Date:2022-08-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY3012567363LF0000X, 363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamilyGroup - Single Specialty
No363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerGroup - Single Specialty