Provider Demographics
NPI:1205931870
Name:MARTINEZ, PATRICIA ELLEN (MSN, APRN-PMH,BC)
Entity type:Individual
Prefix:MRS
First Name:PATRICIA
Middle Name:ELLEN
Last Name:MARTINEZ
Suffix:
Gender:F
Credentials:MSN, APRN-PMH,BC
Other - Prefix:MRS
Other - First Name:PATRICIA
Other - Middle Name:ELLEN
Other - Last Name:LAFOND
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MSN, APRN-PMH,BC
Mailing Address - Street 1:PO BOX 176
Mailing Address - Street 2:
Mailing Address - City:BASYE
Mailing Address - State:VA
Mailing Address - Zip Code:22810-0176
Mailing Address - Country:US
Mailing Address - Phone:540-856-2670
Mailing Address - Fax:
Practice Address - Street 1:WALTER REED ARMY MEDICAL CTR
Practice Address - Street 2:6900 GEORGIA AVE
Practice Address - City:WASHINGTON
Practice Address - State:DC
Practice Address - Zip Code:20307-0001
Practice Address - Country:US
Practice Address - Phone:202-782-9681
Practice Address - Fax:202-782-3072
Is Sole Proprietor?:No
Enumeration Date:2006-09-14
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDR156218163WP0809X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WP0809XNursing Service ProvidersRegistered NursePsychiatric/Mental Health, Adult