Provider Demographics
NPI:1093989717
Name:MARTINDALE, NADIA RAWLS (MSN, APN, ACNS-BC)
Entity Type:Individual
Prefix:
First Name:NADIA
Middle Name:RAWLS
Last Name:MARTINDALE
Suffix:
Gender:F
Credentials:MSN, APN, ACNS-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:139 W LAMAR ST
Mailing Address - Street 2:
Mailing Address - City:JASPER
Mailing Address - State:TX
Mailing Address - Zip Code:75951-4014
Mailing Address - Country:US
Mailing Address - Phone:409-384-6829
Mailing Address - Fax:
Practice Address - Street 1:139 W LAMAR ST
Practice Address - Street 2:
Practice Address - City:JASPER
Practice Address - State:TX
Practice Address - Zip Code:75951-4014
Practice Address - Country:US
Practice Address - Phone:409-384-6829
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-04-14
Last Update Date:2010-11-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX572750364SA2200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes364SA2200XPhysician Assistants & Advanced Practice Nursing ProvidersClinical Nurse SpecialistAdult Health