Provider Demographics
NPI:1851417471
Name:MARTINEZ, KERRI
Entity Type:Individual
Prefix:
First Name:KERRI
Middle Name:
Last Name:MARTINEZ
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:280 EXEPMLA CIRCLE
Mailing Address - Street 2:
Mailing Address - City:LAFAYETTE
Mailing Address - State:CO
Mailing Address - Zip Code:80026
Mailing Address - Country:US
Mailing Address - Phone:720-536-7900
Mailing Address - Fax:720-536-7940
Practice Address - Street 1:280 EXEPMLA CIRCLE
Practice Address - Street 2:
Practice Address - City:LAFAYETTE
Practice Address - State:CO
Practice Address - Zip Code:80026
Practice Address - Country:US
Practice Address - Phone:720-536-7900
Practice Address - Fax:720-536-7940
Is Sole Proprietor?:No
Enumeration Date:2007-03-22
Last Update Date:2009-09-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes376K00000XNursing Service Related ProvidersNurse's Aide
Provider Identifiers
StateIdentifier IDID TypeIssuer
015606OtherKAISER-COMMERCIAL NUMBER