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

Michelle Martin

Individual provider Nurse Practitioner · NPI 1750017604

Michelle Martin is a Nurse Practitioner in Fairmont, West Virginia. Qualified in 2022, 4 years ago. Practices with Grandw Inc, a 90-clinician group and accepts Medicare assignment. Licensed in West Virginia.

Years since qualifying
4
Licensed in
WV
In the registry since
2022
Specialties on file
2

Practice location Address checks out

207 Fairmont Ave
Fairmont, WV 26554-2710
Phone: (681) 404-6869
Fax: (681) 404-6871
Show map & directions

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

Specialties & licences

Nurse Practitioner (primary) Taxonomy 363L00000X · Licence 113712 (WV)
Family Nurse Practitioner Taxonomy 363LF0000X · Licence 113712 (WV)

Record details

NPI number1750017604
Entity typeIndividual (Type 1)
GenderFemale
Sole proprietorNo
NPI enumeratedJuly 25, 2022
Last updated in NPPESNovember 24, 2025
Certification dateNovember 24, 2025
Mailing address207 Fairmont Ave, Fairmont, WV 26554-2710

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyNURSE PRACTITIONER
Medical schoolOTHER
Graduated 2022 (4 years in practice)
Group practice Grandw Inc — 90 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount

Other providers in Fairmont