Provider Demographics
NPI:1013778604
Name:MARTENEY, CAILEY RAE
Entity Type:Individual
Prefix:
First Name:CAILEY
Middle Name:RAE
Last Name:MARTENEY
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7264 ANDORA RD NE
Mailing Address - Street 2:
Mailing Address - City:MECHANICSTOWN
Mailing Address - State:OH
Mailing Address - Zip Code:44651-9011
Mailing Address - Country:US
Mailing Address - Phone:330-314-8853
Mailing Address - Fax:
Practice Address - Street 1:7264 ANDORA RD NE
Practice Address - Street 2:
Practice Address - City:MECHANICSTOWN
Practice Address - State:OH
Practice Address - Zip Code:44651-9011
Practice Address - Country:US
Practice Address - Phone:330-314-8853
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-01-19
Last Update Date:2024-01-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH3747P1801X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3747P1801XNursing Service Related ProvidersTechnicianPersonal Care Attendant