Provider Demographics
NPI:1730676370
Name:MARTELL, ELIZABETH M (FNP-BC PMHNP-BC)
Entity type:Individual
Prefix:
First Name:ELIZABETH
Middle Name:M
Last Name:MARTELL
Suffix:
Gender:F
Credentials:FNP-BC PMHNP-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:30 NORTHAMPTON ST
Mailing Address - Street 2:
Mailing Address - City:BOSTON
Mailing Address - State:MA
Mailing Address - Zip Code:02118-4098
Mailing Address - Country:US
Mailing Address - Phone:617-433-9601
Mailing Address - Fax:617-445-6538
Practice Address - Street 1:201 EDGEWATER DR STE 102
Practice Address - Street 2:
Practice Address - City:WAKEFIELD
Practice Address - State:MA
Practice Address - Zip Code:01880-6202
Practice Address - Country:US
Practice Address - Phone:978-620-0790
Practice Address - Fax:978-975-3300
Is Sole Proprietor?:No
Enumeration Date:2018-04-19
Last Update Date:2025-10-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NH065604-23363LP0808X, 363LF0000X
SC30842363LP0808X, 363LF0000X
ID5971576363LF0000X, 363LP0808X
FLAPRN11041150363LP0808X, 363LF0000X
MARN280401363LP0808X, 363LF0000X
MECNP231004363LF0000X, 363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health
No363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily