Provider Demographics
NPI:1215572060
Name:MARTINEZ-HAKES, DAVID MATTHEW (NP)
Entity Type:Individual
Prefix:MR
First Name:DAVID
Middle Name:MATTHEW
Last Name:MARTINEZ-HAKES
Suffix:
Gender:M
Credentials:NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2109 BRIGHTON DR
Mailing Address - Street 2:
Mailing Address - City:BELLEVUE
Mailing Address - State:NE
Mailing Address - Zip Code:68123-2024
Mailing Address - Country:US
Mailing Address - Phone:402-949-2594
Mailing Address - Fax:
Practice Address - Street 1:710 S 17TH ST
Practice Address - Street 2:
Practice Address - City:OMAHA
Practice Address - State:NE
Practice Address - Zip Code:68102-3108
Practice Address - Country:US
Practice Address - Phone:402-599-2426
Practice Address - Fax:402-599-2351
Is Sole Proprietor?:No
Enumeration Date:2019-11-14
Last Update Date:2021-07-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NE112928363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily