Provider Demographics
NPI:1144013475
Name:MARTINEZ, KELLEY RENEE
Entity type:Individual
Prefix:
First Name:KELLEY
Middle Name:RENEE
Last Name:MARTINEZ
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:172 GREEN ST
Mailing Address - Street 2:
Mailing Address - City:ZANESVILLE
Mailing Address - State:OH
Mailing Address - Zip Code:43701-4514
Mailing Address - Country:US
Mailing Address - Phone:614-783-2822
Mailing Address - Fax:
Practice Address - Street 1:172 GREEN ST
Practice Address - Street 2:
Practice Address - City:ZANESVILLE
Practice Address - State:OH
Practice Address - Zip Code:43701-4514
Practice Address - Country:US
Practice Address - Phone:614-783-2822
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-05-28
Last Update Date:2025-05-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes372600000XNursing Service Related ProvidersAdult Companion