Provider Demographics
NPI:1740469675
Name:MARTIN, CAREN SUZANNE (RN)
Entity type:Individual
Prefix:
First Name:CAREN
Middle Name:SUZANNE
Last Name:MARTIN
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1135 SW WOODWARD AVE
Mailing Address - Street 2:
Mailing Address - City:TOPEKA
Mailing Address - State:KS
Mailing Address - Zip Code:66604-3922
Mailing Address - Country:US
Mailing Address - Phone:785-215-3921
Mailing Address - Fax:
Practice Address - Street 1:1135 SW WOODWARD AVE
Practice Address - Street 2:
Practice Address - City:TOPEKA
Practice Address - State:KS
Practice Address - Zip Code:66604-3922
Practice Address - Country:US
Practice Address - Phone:785-215-3921
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-10-27
Last Update Date:2007-10-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS13-55383-081163WP0809X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WP0809XNursing Service ProvidersRegistered NursePsychiatric/Mental Health, Adult