Provider Demographics
NPI:1790438935
Name:MARTINEZ, CYNTHIA J (MSN, APRN, FNP-BC)
Entity Type:Individual
Prefix:
First Name:CYNTHIA
Middle Name:J
Last Name:MARTINEZ
Suffix:
Gender:F
Credentials:MSN, APRN, FNP-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1433 RAVENA ST
Mailing Address - Street 2:
Mailing Address - City:BETHLEHEM
Mailing Address - State:PA
Mailing Address - Zip Code:18015-9425
Mailing Address - Country:US
Mailing Address - Phone:484-895-8201
Mailing Address - Fax:
Practice Address - Street 1:1221 21ST AVE N
Practice Address - Street 2:
Practice Address - City:MYRTLE BEACH
Practice Address - State:SC
Practice Address - Zip Code:29577-7402
Practice Address - Country:US
Practice Address - Phone:843-626-9379
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-01-28
Last Update Date:2022-03-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC25739363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily