Provider Demographics
NPI:1013718139
Name:MARTINEZ, YISSY CORALIA (FNP-C)
Entity type:Individual
Prefix:
First Name:YISSY
Middle Name:CORALIA
Last Name:MARTINEZ
Suffix:
Gender:F
Credentials:FNP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:812 STONE CREST CIR
Mailing Address - Street 2:
Mailing Address - City:CHATTANOOGA
Mailing Address - State:TN
Mailing Address - Zip Code:37421-4541
Mailing Address - Country:US
Mailing Address - Phone:317-695-8648
Mailing Address - Fax:
Practice Address - Street 1:100 MITCHELL RD
Practice Address - Street 2:
Practice Address - City:FORT OGLETHORPE
Practice Address - State:GA
Practice Address - Zip Code:30742-3683
Practice Address - Country:US
Practice Address - Phone:706-866-5520
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-03-24
Last Update Date:2025-05-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GAGAA-NP003333363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily