Provider Demographics
NPI:1518503374
Name:MARTINEZ, M. EMILIA (RN)
Entity Type:Individual
Prefix:
First Name:M.
Middle Name:EMILIA
Last Name:MARTINEZ
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 1:9540 STONE RIDGE DR NW
Mailing Address - Street 2:
Mailing Address - City:ALBUQUERQUE
Mailing Address - State:NM
Mailing Address - Zip Code:87114-3006
Mailing Address - Country:US
Mailing Address - Phone:505-429-1716
Mailing Address - Fax:505-212-0447
Practice Address - Street 1:9540 STONE RIDGE DR NW
Practice Address - Street 2:
Practice Address - City:ALBUQUERQUE
Practice Address - State:NM
Practice Address - Zip Code:87114-3006
Practice Address - Country:US
Practice Address - Phone:505-429-1716
Practice Address - Fax:505-212-0447
Is Sole Proprietor?:No
Enumeration Date:2019-11-26
Last Update Date:2019-11-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NMR42147163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse
Provider Identifiers
StateIdentifier IDID TypeIssuer
NM84-3345400OtherHOME HEALTH CARE