Provider Demographics
NPI:1891045779
Name:BADGER, MARTHA A (APRN)
Entity Type:Individual
Prefix:
First Name:MARTHA
Middle Name:A
Last Name:BADGER
Suffix:
Gender:F
Credentials:APRN
Other - Prefix:
Other - First Name:MARTHA
Other - Middle Name:A,
Other - Last Name:AKER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:823 SW MULVANE ST
Mailing Address - Street 2:
Mailing Address - City:TOPEKA
Mailing Address - State:KS
Mailing Address - Zip Code:66606-1764
Mailing Address - Country:US
Mailing Address - Phone:785-354-9591
Mailing Address - Fax:
Practice Address - Street 1:823 SW MULVANE ST
Practice Address - Street 2:
Practice Address - City:TOPEKA
Practice Address - State:KS
Practice Address - Zip Code:66606-1764
Practice Address - Country:US
Practice Address - Phone:785-354-9591
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-09-18
Last Update Date:2023-07-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS53-75759363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
Provider Identifiers
StateIdentifier IDID TypeIssuer
KS068002192OtherMEDICARE PTAN
KS200970220AMedicaid