Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.

Illexus Martin

Individual provider Student in an Organized Health Care Education/Training Program · NPI 1790359255

Illexus Martin is a Student in an Organized Health Care Education/Training Program in Saint Paul, Minnesota. Registered with an NPI since 2021.

In the registry since
2021
Specialties on file
2

Practice location Address checks out

1575 Laurel Ave Apt B
Saint Paul, MN 55104-7494
Phone: (763) 477-1743
Show map & directions

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Athletic Trainer (primary) Taxonomy 2255A2300X
Student in an Organized Health Care Education/Training Program Taxonomy 390200000X

Record details

NPI number1790359255
Entity typeIndividual (Type 1)
GenderFemale
Sole proprietorNo
NPI enumeratedMay 18, 2021
Last updated in NPPESMay 18, 2021
Certification dateMay 18, 2021

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