Provider Demographics
NPI:1437299591
Name:BORDEN, MARTINA LOUISE (RN)
Entity Type:Individual
Prefix:MRS
First Name:MARTINA
Middle Name:LOUISE
Last Name:BORDEN
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:9860 HIGHWAY 96 WEST
Mailing Address - Street 2:
Mailing Address - City:PUEBLO
Mailing Address - State:CO
Mailing Address - Zip Code:81253
Mailing Address - Country:US
Mailing Address - Phone:719-784-2155
Mailing Address - Fax:719-583-4439
Practice Address - Street 1:151 CENTRAL MAIN ST
Practice Address - Street 2:PUEBLO CITY-COUNTY HEALTH DEPARTMENT
Practice Address - City:PUEBLO
Practice Address - State:CO
Practice Address - Zip Code:81003-4212
Practice Address - Country:US
Practice Address - Phone:719-583-4431
Practice Address - Fax:719-583-4439
Is Sole Proprietor?:No
Enumeration Date:2007-02-07
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO68503163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse