Provider Demographics
NPI:1922400761
Name:MARTERRE, ELIZABETH NICOLE (CPM)
Entity Type:Individual
Prefix:
First Name:ELIZABETH
Middle Name:NICOLE
Last Name:MARTERRE
Suffix:
Gender:F
Credentials:CPM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5315 FREE UNION RD
Mailing Address - Street 2:
Mailing Address - City:FREE UNION
Mailing Address - State:VA
Mailing Address - Zip Code:22940-1920
Mailing Address - Country:US
Mailing Address - Phone:512-745-9635
Mailing Address - Fax:
Practice Address - Street 1:5315 FREE UNION RD
Practice Address - Street 2:
Practice Address - City:FREE UNION
Practice Address - State:VA
Practice Address - Zip Code:22940-1920
Practice Address - Country:US
Practice Address - Phone:512-745-9635
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-09-24
Last Update Date:2023-03-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
374J00000X
TX99288176B00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes176B00000XOther Service ProvidersMidwife
No374J00000XNursing Service Related ProvidersDoula