Provider Demographics
NPI:1669463857
Name:MARTINEK, CAROLINE R (CNP,MPH,MSN,FNP-BC)
Entity type:Individual
Prefix:MS
First Name:CAROLINE
Middle Name:R
Last Name:MARTINEK
Suffix:
Gender:
Credentials:CNP,MPH,MSN,FNP-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:1304 ARVILLA AVE NW
Mailing Address - Street 2:
Mailing Address - City:ALBUQUERQUE
Mailing Address - State:NM
Mailing Address - Zip Code:87107-2710
Mailing Address - Country:US
Mailing Address - Phone:505-288-8206
Mailing Address - Fax:
Practice Address - Street 1:1 UNIVERSITY OF NEW MEXICO
Practice Address - Street 2:MSC06 3870
Practice Address - City:ALBUQUERQUE
Practice Address - State:NM
Practice Address - Zip Code:87131-0001
Practice Address - Country:US
Practice Address - Phone:505-277-3136
Practice Address - Fax:505-277-2020
Is Sole Proprietor?:No
Enumeration Date:2005-11-04
Last Update Date:2025-05-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NMCNP01077163WS0200X, 363LF0000X
NMR45196363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No163WS0200XNursing Service ProvidersRegistered NurseSchool
Provider Identifiers
StateIdentifier IDID TypeIssuer
NM75426Medicaid
NMS99923Medicare ID - Type UnspecifiedCNP