Provider Demographics
NPI:1164716916
Name:HOLE, MARTIANNE (RNFA)
Entity Type:Individual
Prefix:MRS
First Name:MARTIANNE
Middle Name:
Last Name:HOLE
Suffix:
Gender:F
Credentials:RNFA
Other - Prefix:MRS
Other - First Name:MARTIANNE
Other - Middle Name:HAWKINS
Other - Last Name:HOLE
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:RNFA
Mailing Address - Street 1:9600 BROADWAY EXT
Mailing Address - Street 2:
Mailing Address - City:OKLAHOMA CITY
Mailing Address - State:OK
Mailing Address - Zip Code:73114-7408
Mailing Address - Country:US
Mailing Address - Phone:405-486-2161
Mailing Address - Fax:405-486-2165
Practice Address - Street 1:9600 BROADWAY EXT
Practice Address - Street 2:
Practice Address - City:OKLAHOMA CITY
Practice Address - State:OK
Practice Address - Zip Code:73114-7408
Practice Address - Country:US
Practice Address - Phone:405-486-2161
Practice Address - Fax:405-486-2165
Is Sole Proprietor?:Yes
Enumeration Date:2011-06-08
Last Update Date:2011-06-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OKR82388163WX0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WX0800XNursing Service ProvidersRegistered NurseOrthopedic