Provider Demographics
NPI:1194610147
Name:MARTIN, SHARYL LYNESE
Entity type:Individual
Prefix:
First Name:SHARYL
Middle Name:LYNESE
Last Name:MARTIN
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 1:2009 DELAWARE AVE APT B
Mailing Address - Street 2:
Mailing Address - City:FORT PIERCE
Mailing Address - State:FL
Mailing Address - Zip Code:34950-5822
Mailing Address - Country:US
Mailing Address - Phone:772-877-9536
Mailing Address - Fax:
Practice Address - Street 1:2009 DELAWARE AVE APT B
Practice Address - Street 2:
Practice Address - City:FORT PIERCE
Practice Address - State:FL
Practice Address - Zip Code:34950-5822
Practice Address - Country:US
Practice Address - Phone:772-877-9536
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-06-10
Last Update Date:2025-06-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLRN9464590163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse