Provider Demographics
NPI:1275203838
Name:MARTINEZ, KRYSTLE NICOLE (APRN, FNP-C)
Entity Type:Individual
Prefix:
First Name:KRYSTLE
Middle Name:NICOLE
Last Name:MARTINEZ
Suffix:
Gender:F
Credentials:APRN, FNP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6113 SARATOGA BLVD STE F
Mailing Address - Street 2:#159
Mailing Address - City:CORPUS CHRISTI
Mailing Address - State:TX
Mailing Address - Zip Code:78414-2492
Mailing Address - Country:US
Mailing Address - Phone:361-510-1631
Mailing Address - Fax:
Practice Address - Street 1:3301 S ALAMEDA ST STE 201
Practice Address - Street 2:
Practice Address - City:CORPUS CHRISTI
Practice Address - State:TX
Practice Address - Zip Code:78411-1870
Practice Address - Country:US
Practice Address - Phone:361-857-2900
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-09-15
Last Update Date:2021-09-15
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
TX1054546363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily