Provider Demographics
NPI:1013174473
Name:MARTIN, JANICE KAY (RN)
Entity type:Individual
Prefix:MRS
First Name:JANICE
Middle Name:KAY
Last Name:MARTIN
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8924 KINCAID CT
Mailing Address - Street 2:
Mailing Address - City:BENBROOK
Mailing Address - State:TX
Mailing Address - Zip Code:76116-1344
Mailing Address - Country:US
Mailing Address - Phone:817-228-8277
Mailing Address - Fax:
Practice Address - Street 1:8924 KINCAID CT
Practice Address - Street 2:
Practice Address - City:BENBROOK
Practice Address - State:TX
Practice Address - Zip Code:76116-1344
Practice Address - Country:US
Practice Address - Phone:817-228-8277
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-05-21
Last Update Date:2008-05-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX501984163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse