Provider Demographics
NPI:1578836888
Name:MERAVIGLIA, MARTHA (RN, ACNS-BC)
Entity Type:Individual
Prefix:
First Name:MARTHA
Middle Name:
Last Name:MERAVIGLIA
Suffix:
Gender:F
Credentials:RN, ACNS-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7917 CRANDALL RD
Mailing Address - Street 2:
Mailing Address - City:AUSTIN
Mailing Address - State:TX
Mailing Address - Zip Code:78739-1910
Mailing Address - Country:US
Mailing Address - Phone:512-258-8119
Mailing Address - Fax:
Practice Address - Street 1:700 W WHITESTONE BLVD
Practice Address - Street 2:
Practice Address - City:CEDAR PARK
Practice Address - State:TX
Practice Address - Zip Code:78613-2119
Practice Address - Country:US
Practice Address - Phone:512-331-5828
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-02-16
Last Update Date:2016-01-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX229015163WM0705X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WM0705XNursing Service ProvidersRegistered NurseMedical-Surgical