Provider Demographics
NPI:1710298112
Name:MARTI, EMILY JEANNE (CRNP)
Entity Type:Individual
Prefix:MRS
First Name:EMILY
Middle Name:JEANNE
Last Name:MARTI
Suffix:
Gender:F
Credentials:CRNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6095 MARSHALEE DRIVE
Mailing Address - Street 2:
Mailing Address - City:ELKRIDGE
Mailing Address - State:MD
Mailing Address - Zip Code:21075
Mailing Address - Country:US
Mailing Address - Phone:301-395-3003
Mailing Address - Fax:
Practice Address - Street 1:6095 MARSHALEE DRIVE
Practice Address - Street 2:
Practice Address - City:ELKRIDGE
Practice Address - State:MD
Practice Address - Zip Code:21075
Practice Address - Country:US
Practice Address - Phone:410-379-3500
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2010-06-30
Last Update Date:2010-06-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDR172575363LA2200X, 363LG0600X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LG0600XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerGerontology
No363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health