Provider Demographics
NPI:1346895174
Name:MARTIN, FELICIA ANN (RN)
Entity Type:Individual
Prefix:
First Name:FELICIA
Middle Name:ANN
Last Name:MARTIN
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:919 16TH ST
Mailing Address - Street 2:
Mailing Address - City:AUBURN
Mailing Address - State:NE
Mailing Address - Zip Code:68305-2208
Mailing Address - Country:US
Mailing Address - Phone:402-274-4354
Mailing Address - Fax:402-274-4356
Practice Address - Street 1:919 16TH ST
Practice Address - Street 2:
Practice Address - City:AUBURN
Practice Address - State:NE
Practice Address - Zip Code:68305-2208
Practice Address - Country:US
Practice Address - Phone:402-274-4354
Practice Address - Fax:402-274-4356
Is Sole Proprietor?:Yes
Enumeration Date:2019-08-08
Last Update Date:2019-08-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NE86374163WC1500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WC1500XNursing Service ProvidersRegistered NurseCommunity Health