Provider Demographics
NPI:1518346527
Name:MARTIN, MARILYN FRANCES (RN, MSN, NP-C)
Entity Type:Individual
Prefix:
First Name:MARILYN
Middle Name:FRANCES
Last Name:MARTIN
Suffix:
Gender:F
Credentials:RN, MSN, NP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Mailing Address - Street 1:6023 VICKI LYNN LN
Mailing Address - Street 2:
Mailing Address - City:RICHMOND
Mailing Address - State:TX
Mailing Address - Zip Code:77406-8638
Mailing Address - Country:US
Mailing Address - Phone:832-282-3531
Mailing Address - Fax:
Practice Address - Street 1:6023 VICKI LYNN LN
Practice Address - Street 2:
Practice Address - City:RICHMOND
Practice Address - State:TX
Practice Address - Zip Code:77406-8638
Practice Address - Country:US
Practice Address - Phone:832-282-3531
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-05-22
Last Update Date:2015-05-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXAP127650363LA2200X, 363LG0600X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health
No363LG0600XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerGerontology