Provider Demographics
NPI:1265934848
Name:MARTINEZ, CANDACE RENEE (LVN)
Entity type:Individual
Prefix:
First Name:CANDACE
Middle Name:RENEE
Last Name:MARTINEZ
Suffix:
Gender:F
Credentials:LVN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5304 SILTSTONE LOOP
Mailing Address - Street 2:
Mailing Address - City:KILLEEN
Mailing Address - State:TX
Mailing Address - Zip Code:76542-5779
Mailing Address - Country:US
Mailing Address - Phone:214-796-0418
Mailing Address - Fax:
Practice Address - Street 1:5304 SILTSTONE LOOP
Practice Address - Street 2:
Practice Address - City:KILLEEN
Practice Address - State:TX
Practice Address - Zip Code:76542-5779
Practice Address - Country:US
Practice Address - Phone:214-796-0418
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-02-28
Last Update Date:2018-02-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX334202164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse