Provider Demographics
NPI:1154090439
Name:MARTINEZ, MARIBEL (RN)
Entity Type:Individual
Prefix:
First Name:MARIBEL
Middle Name:
Last Name:MARTINEZ
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:100 K. JOHNSON BLVD N.
Mailing Address - Street 2:2ND FLOOR
Mailing Address - City:BORDENTOWN
Mailing Address - State:NJ
Mailing Address - Zip Code:08505-4713
Mailing Address - Country:US
Mailing Address - Phone:609-528-8884
Mailing Address - Fax:609-528-8886
Practice Address - Street 1:100 K JOHNSON BLVD
Practice Address - Street 2:
Practice Address - City:BORDENTOWN
Practice Address - State:NJ
Practice Address - Zip Code:08505-2275
Practice Address - Country:US
Practice Address - Phone:609-528-8894
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-09-09
Last Update Date:2021-12-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ26NR15986500163W00000X
NJ26NJ01223700363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
No163W00000XNursing Service ProvidersRegistered Nurse