Provider Demographics
NPI:1306602784
Name:MARTIN, JOHN T (RN)
Entity type:Individual
Prefix:
First Name:JOHN
Middle Name:T
Last Name:MARTIN
Suffix:
Gender:M
Credentials:RN
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Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:ROCKY MOUNTAIN REGIONAL VA MEDICAL CENTER/CAREGIVER PRO
Mailing Address - Street 2:1700 NORTH WHEELING STREET
Mailing Address - City:AURORA
Mailing Address - State:CO
Mailing Address - Zip Code:80045
Mailing Address - Country:US
Mailing Address - Phone:720-723-3013
Mailing Address - Fax:
Practice Address - Street 1:ROCKY MOUNTAIN REGIONAL VA MEDICAL CENTER/CAREGIVER PRO
Practice Address - Street 2:1700 NORTH WHEELING STREET
Practice Address - City:AURORA
Practice Address - State:CO
Practice Address - Zip Code:80045
Practice Address - Country:US
Practice Address - Phone:720-723-3013
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-02-23
Last Update Date:2024-02-23
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
CORN0197862163WC0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WC0400XNursing Service ProvidersRegistered NurseCase Management