Provider Demographics
NPI:1861678914
Name:MARTINEZ, GERALYN MARY (APRN, FNP)
Entity Type:Individual
Prefix:MS
First Name:GERALYN
Middle Name:MARY
Last Name:MARTINEZ
Suffix:
Gender:F
Credentials:APRN, FNP
Other - Prefix:MISS
Other - First Name:GERALYN
Other - Middle Name:MARY
Other - Last Name:GUTIERREZ
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:535 ADAMS ST
Mailing Address - Street 2:
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78210-1201
Mailing Address - Country:US
Mailing Address - Phone:210-534-5702
Mailing Address - Fax:
Practice Address - Street 1:535 ADAMS ST
Practice Address - Street 2:
Practice Address - City:SAN ANTONIO
Practice Address - State:TX
Practice Address - Zip Code:78210-1201
Practice Address - Country:US
Practice Address - Phone:210-534-5702
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-01-18
Last Update Date:2008-01-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX500472363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily