Provider Demographics
NPI:1659524841
Name:MARTIN, MARSHA DENISE (HOMEHEALTH AID)
Entity Type:Individual
Prefix:
First Name:MARSHA
Middle Name:DENISE
Last Name:MARTIN
Suffix:
Gender:F
Credentials:HOMEHEALTH AID
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 181358
Mailing Address - Street 2:
Mailing Address - City:ARLINGTON
Mailing Address - State:TX
Mailing Address - Zip Code:76096-1358
Mailing Address - Country:US
Mailing Address - Phone:817-404-8825
Mailing Address - Fax:
Practice Address - Street 1:767 STH. FIELDER RD
Practice Address - Street 2:#5
Practice Address - City:ARLINGTON
Practice Address - State:TX
Practice Address - Zip Code:76013-1785
Practice Address - Country:US
Practice Address - Phone:817-404-8825
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-10-31
Last Update Date:2009-08-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXNA00842666374U00000X, 376K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374U00000XNursing Service Related ProvidersHome Health Aide
No376K00000XNursing Service Related ProvidersNurse's Aide