Provider Demographics
NPI:1598159725
Name:MARTINEZ, NELSON ANDRES (APNP)
Entity Type:Individual
Prefix:
First Name:NELSON
Middle Name:ANDRES
Last Name:MARTINEZ
Suffix:
Gender:M
Credentials:APNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2957 CHRISTOPHERS CT
Mailing Address - Street 2:
Mailing Address - City:MARIETTA
Mailing Address - State:GA
Mailing Address - Zip Code:30062-1632
Mailing Address - Country:US
Mailing Address - Phone:631-833-4969
Mailing Address - Fax:
Practice Address - Street 1:6158 HIGHWAY 92 STE 101
Practice Address - Street 2:
Practice Address - City:ACWORTH
Practice Address - State:GA
Practice Address - Zip Code:30102-2332
Practice Address - Country:US
Practice Address - Phone:770-928-8450
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-03-25
Last Update Date:2023-11-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA304171100000X
GARN313157363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No171100000XOther Service ProvidersAcupuncturist