Provider Demographics
NPI:1295478022
Name:MARTINI, KRISTI ANNE
Entity type:Individual
Prefix:
First Name:KRISTI
Middle Name:ANNE
Last Name:MARTINI
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 1:3962 WILSONBURG RD
Mailing Address - Street 2:
Mailing Address - City:REYNOLDSVILLE
Mailing Address - State:WV
Mailing Address - Zip Code:26422
Mailing Address - Country:US
Mailing Address - Phone:304-672-0140
Mailing Address - Fax:
Practice Address - Street 1:3962 WILSONBURG RD
Practice Address - Street 2:
Practice Address - City:REYNOLDSVILLE
Practice Address - State:WV
Practice Address - Zip Code:26422
Practice Address - Country:US
Practice Address - Phone:304-672-0140
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-04-19
Last Update Date:2022-04-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3747P1801XNursing Service Related ProvidersTechnicianPersonal Care Attendant