Provider Demographics
NPI:1720845944
Name:MARTINEZ, LAURA LORENA-LOPEZ
Entity Type:Individual
Prefix:
First Name:LAURA
Middle Name:LORENA-LOPEZ
Last Name:MARTINEZ
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 1:9501 W SAHARA AVE APT 2275
Mailing Address - Street 2:
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89117-5337
Mailing Address - Country:US
Mailing Address - Phone:702-487-1033
Mailing Address - Fax:
Practice Address - Street 1:9501 W SAHARA AVE APT 2275
Practice Address - Street 2:
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89117-5337
Practice Address - Country:US
Practice Address - Phone:702-487-1033
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-03-04
Last Update Date:2024-03-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374U00000XNursing Service Related ProvidersHome Health Aide