Provider Demographics
NPI:1053340760
Name:COMSTOCK, MARTHA LYNN (ARNP)
Entity type:Individual
Prefix:MS
First Name:MARTHA
Middle Name:LYNN
Last Name:COMSTOCK
Suffix:
Gender:F
Credentials:ARNP
Other - Prefix:
Other - First Name:MARTHA
Other - Middle Name:LYNN D
Other - Last Name:COMSTOCK
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:PO BOX 918025
Mailing Address - Street 2:
Mailing Address - City:ORLANDO
Mailing Address - State:FL
Mailing Address - Zip Code:32891-8025
Mailing Address - Country:US
Mailing Address - Phone:352-265-8205
Mailing Address - Fax:352-392-9724
Practice Address - Street 1:1600 SW ARCHER RD
Practice Address - Street 2:
Practice Address - City:GAINESVILLE
Practice Address - State:FL
Practice Address - Zip Code:32610-3003
Practice Address - Country:US
Practice Address - Phone:352-265-8205
Practice Address - Fax:352-392-9724
Is Sole Proprietor?:No
Enumeration Date:2006-07-03
Last Update Date:2008-03-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLARNP845382363LW0102X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LW0102XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerWomen's Health