Provider Demographics
NPI:1457446254
Name:MARTINEZ, NANCY ANN (RD)
Entity Type:Individual
Prefix:
First Name:NANCY
Middle Name:ANN
Last Name:MARTINEZ
Suffix:
Gender:F
Credentials:RD
Other - Prefix:
Other - First Name:NANCY
Other - Middle Name:ANN
Other - Last Name:CHATFIELD
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:RD
Mailing Address - Street 1:1240 E BUSINESS HIGHWAY 83
Mailing Address - Street 2:LOT 75
Mailing Address - City:MISSION
Mailing Address - State:TX
Mailing Address - Zip Code:78572-9329
Mailing Address - Country:US
Mailing Address - Phone:956-618-7110
Mailing Address - Fax:956-618-7122
Practice Address - Street 1:2101 S COL ROWE BLVD
Practice Address - Street 2:
Practice Address - City:MCALLEN
Practice Address - State:TX
Practice Address - Zip Code:78503-1272
Practice Address - Country:US
Practice Address - Phone:956-618-7110
Practice Address - Fax:956-618-7122
Is Sole Proprietor?:No
Enumeration Date:2006-10-04
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
475373133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX87311VOtherBLUE CROSS BLUE SHIELD