Provider Demographics
NPI:1669271466
Name:MARTINEZ, GISELLE
Entity type:Individual
Prefix:
First Name:GISELLE
Middle Name:
Last Name:MARTINEZ
Suffix:
Gender:
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:899 N LOGAN ST STE 407
Mailing Address - Street 2:
Mailing Address - City:DENVER
Mailing Address - State:CO
Mailing Address - Zip Code:80203-3155
Mailing Address - Country:US
Mailing Address - Phone:303-284-8674
Mailing Address - Fax:888-710-3082
Practice Address - Street 1:899 N LOGAN ST STE 407
Practice Address - Street 2:
Practice Address - City:DENVER
Practice Address - State:CO
Practice Address - Zip Code:80203-3155
Practice Address - Country:US
Practice Address - Phone:303-284-8674
Practice Address - Fax:888-710-3082
Is Sole Proprietor?:No
Enumeration Date:2025-03-12
Last Update Date:2025-03-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
374700000X, 246Z00000X
CONA.008239833747P1801X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes246Z00000XTechnologists, Technicians & Other Technical Service ProvidersSpecialist/Technologist, Other
No374700000XNursing Service Related ProvidersTechnician
No3747P1801XNursing Service Related ProvidersTechnicianPersonal Care Attendant