Provider Demographics
NPI:1326353335
Name:MARTIN, ALEXANDER DAVID (RN)
Entity Type:Individual
Prefix:
First Name:ALEXANDER
Middle Name:DAVID
Last Name:MARTIN
Suffix:
Gender:M
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:24941 E EUCLID PL
Mailing Address - Street 2:
Mailing Address - City:AURORA
Mailing Address - State:CO
Mailing Address - Zip Code:80016-2464
Mailing Address - Country:US
Mailing Address - Phone:303-617-8207
Mailing Address - Fax:
Practice Address - Street 1:275 SOUTH ASPEN STREET, STOP 89
Practice Address - Street 2:460 MDG/SGHC
Practice Address - City:BUCKLEY AFB
Practice Address - State:CO
Practice Address - Zip Code:80011-9547
Practice Address - Country:US
Practice Address - Phone:720-847-6486
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-08-13
Last Update Date:2010-08-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO193067163W00000X
CA505191163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse