Provider Demographics
NPI:1669947230
Name:MARTIN, BRI-ANNA MARIE (RN)
Entity type:Individual
Prefix:
First Name:BRI-ANNA
Middle Name:MARIE
Last Name:MARTIN
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:BRI-ANNA
Other - Middle Name:MARIE
Other - Last Name:MUNCEY
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:25 CHAPEL RD
Mailing Address - Street 2:
Mailing Address - City:CHURCHVILLE
Mailing Address - State:VA
Mailing Address - Zip Code:24421-2721
Mailing Address - Country:US
Mailing Address - Phone:540-312-2980
Mailing Address - Fax:
Practice Address - Street 1:424 SAVANNAH RD
Practice Address - Street 2:
Practice Address - City:LEWES
Practice Address - State:DE
Practice Address - Zip Code:19958-1462
Practice Address - Country:US
Practice Address - Phone:302-645-3300
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-10-09
Last Update Date:2018-10-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0001252527163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse