Provider Demographics
NPI:1609850155
Name:MARTINEAU, MICHELLE DENISE (WHCNP)
Entity Type:Individual
Prefix:MS
First Name:MICHELLE
Middle Name:DENISE
Last Name:MARTINEAU
Suffix:
Gender:F
Credentials:WHCNP
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Mailing Address - Street 1:5300 N INDEPENDENCE AVE
Mailing Address - Street 2:280
Mailing Address - City:OKLAHOMA CITY
Mailing Address - State:OK
Mailing Address - Zip Code:73112-5556
Mailing Address - Country:US
Mailing Address - Phone:580-977-1903
Mailing Address - Fax:580-548-1434
Practice Address - Street 1:601 W GARRIOTT RD
Practice Address - Street 2:
Practice Address - City:ENID
Practice Address - State:OK
Practice Address - Zip Code:73701-5524
Practice Address - Country:US
Practice Address - Phone:580-977-1903
Practice Address - Fax:580-548-1434
Is Sole Proprietor?:No
Enumeration Date:2005-11-29
Last Update Date:2018-02-12
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
OK100587363LX0001X, 363LX0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LX0001XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerObstetrics & Gynecology