Provider Demographics
NPI:1043412638
Name:MARTENS, JOHN J (APRN)
Entity Type:Individual
Prefix:
First Name:JOHN
Middle Name:J
Last Name:MARTENS
Suffix:
Gender:M
Credentials:APRN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4816 PENINSULA POINTE DR
Mailing Address - Street 2:
Mailing Address - City:HERMITAGE
Mailing Address - State:TN
Mailing Address - Zip Code:37076-3662
Mailing Address - Country:US
Mailing Address - Phone:615-902-7461
Mailing Address - Fax:615-902-7706
Practice Address - Street 1:221 STEWARTS FERRY PIKE
Practice Address - Street 2:
Practice Address - City:NASHVILLE
Practice Address - State:TN
Practice Address - Zip Code:37214-3325
Practice Address - Country:US
Practice Address - Phone:615-902-7461
Practice Address - Fax:615-902-7706
Is Sole Proprietor?:No
Enumeration Date:2007-06-05
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TNAPN0000005801363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health