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Mrs. Jacqueline Wilson Martin
Lodging Provider in Reidsville, North Carolina
NPI 1073667226

Jacqueline Wilson Martin is a Lodging Provider based in Eden, NC. Jacqueline Wilson Martin practices in Reidsville, NC. The NPI Number for Jacqueline Wilson Martin is 1073667226 and holds a License No. FCL-079-037 (North Carolina).

The current practice location address for Jacqueline Wilson Martin is 538 Warriner St, Reidsville, NC and can be reached out via phone at 336-348-6902.

Location: 538 Warriner St, Reidsville, NC, 27288-5025
Profile Details Legacy Identifiers Practice Address Mailing Address Primary Taxonomy
person
Provider Profile Details
NPI Number
1073667226
Provider Name
Jacqueline Wilson Martin
Credential
Provider Entity Type
Individual
Gender
Female
Address
538 Warriner St, Reidsville, NC, 27288-5025
Phone Number
336-348-6902
Fax Number
Provider Enumeration Date
01/23/2007
Last Update Date
03/08/2024
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Provider's Legacy Identifiers
Identifier Type State Issuer
7803777 05 NC
institution
Provider Business Practice Location Address Details
Address
538 Warriner St
City
Reidsville
State
North Carolina
Zip
27320-3053
Phone Number
336-348-6902
Fax Number
person
Provider Business Mailing Address Details
Address
538 Warriner St
City
Reidsville
State
North Carolina
Zip
27320-3053
Phone Number
336-348-6902
Fax Number
person
Provider's Taxonomy Details 1
Type
Other Service Providers
Classification
Lodging
Speciality
-
Taxonomy
177F00000X
License No.
FCL-079-037 (North Carolina)
Definition
A public or privately owned facility providing overnight lodging to individuals traveling long distances or receiving prolonged outpatient medical services away from home.
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