Provider Demographics
NPI:1285666867
Name:MARTINS, CAROL (CRNA)
Entity Type:Individual
Prefix:MRS
First Name:CAROL
Middle Name:
Last Name:MARTINS
Suffix:
Gender:F
Credentials:CRNA
Other - Prefix:MS
Other - First Name:CAROL
Other - Middle Name:
Other - Last Name:MULE'
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:CRNA
Mailing Address - Street 1:201 GUM CT
Mailing Address - Street 2:
Mailing Address - City:SUFFOLK
Mailing Address - State:VA
Mailing Address - Zip Code:23435-2265
Mailing Address - Country:US
Mailing Address - Phone:757-483-5803
Mailing Address - Fax:
Practice Address - Street 1:355 CRAWFORD ST
Practice Address - Street 2:SUITE 808
Practice Address - City:PORTSMOUTH
Practice Address - State:VA
Practice Address - Zip Code:23704-2816
Practice Address - Country:US
Practice Address - Phone:757-399-7451
Practice Address - Fax:757-399-1158
Is Sole Proprietor?:No
Enumeration Date:2006-07-06
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0024074115367500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367500000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Anesthetist, Certified Registered