Provider Demographics
NPI:1518079201
Name:MARTIN, BERNADINE FRANCES (RN,C)
Entity Type:Individual
Prefix:MS
First Name:BERNADINE
Middle Name:FRANCES
Last Name:MARTIN
Suffix:
Gender:F
Credentials:RN,C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:21813 WATSON RD
Mailing Address - Street 2:
Mailing Address - City:LEESBURG
Mailing Address - State:VA
Mailing Address - Zip Code:20175-6508
Mailing Address - Country:US
Mailing Address - Phone:703-327-4570
Mailing Address - Fax:
Practice Address - Street 1:21641 RIDGETOP CIR
Practice Address - Street 2:SUITE 105
Practice Address - City:STERLING
Practice Address - State:VA
Practice Address - Zip Code:20166-6597
Practice Address - Country:US
Practice Address - Phone:571-258-3026
Practice Address - Fax:571-258-3032
Is Sole Proprietor?:No
Enumeration Date:2006-08-31
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0001078571163WC0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WC0400XNursing Service ProvidersRegistered NurseCase Management