Provider Demographics
NPI:1063502805
Name:MARTE, VENECIA M (PA)
Entity Type:Individual
Prefix:
First Name:VENECIA
Middle Name:M
Last Name:MARTE
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Gender:F
Credentials:PA
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Mailing Address - Street 1:1310 CHESTNUT MOUNTAIN RD APT 4T
Mailing Address - Street 2:
Mailing Address - City:CANTON
Mailing Address - State:NC
Mailing Address - Zip Code:28716-9473
Mailing Address - Country:US
Mailing Address - Phone:718-683-8327
Mailing Address - Fax:
Practice Address - Street 1:1914 SMOKY PARK HWY
Practice Address - Street 2:
Practice Address - City:CANDLER
Practice Address - State:NC
Practice Address - Zip Code:28715-9367
Practice Address - Country:US
Practice Address - Phone:828-285-0622
Practice Address - Fax:828-285-9831
Is Sole Proprietor?:No
Enumeration Date:2006-10-13
Last Update Date:2023-08-29
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Provider Licenses
StateLicense IDTaxonomies
NC0010-13176363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant