Provider Demographics
NPI:1134835259
Name:MARTINEZ, KRISTINA C (LPN)
Entity type:Individual
Prefix:
First Name:KRISTINA
Middle Name:C
Last Name:MARTINEZ
Suffix:
Gender:F
Credentials:LPN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3407 W DAKOTA AVE
Mailing Address - Street 2:
Mailing Address - City:DENVER
Mailing Address - State:CO
Mailing Address - Zip Code:80219-2733
Mailing Address - Country:US
Mailing Address - Phone:720-975-3390
Mailing Address - Fax:
Practice Address - Street 1:5300 W ALAMEDA AVE
Practice Address - Street 2:
Practice Address - City:LAKEWOOD
Practice Address - State:CO
Practice Address - Zip Code:80226-3606
Practice Address - Country:US
Practice Address - Phone:720-762-5284
Practice Address - Fax:720-310-2010
Is Sole Proprietor?:No
Enumeration Date:2023-01-24
Last Update Date:2023-01-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO0337693164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse