Provider Demographics
NPI:1740893338
Name:MARTIN, DANA YVETTA (CNA)
Entity type:Individual
Prefix:MS
First Name:DANA
Middle Name:YVETTA
Last Name:MARTIN
Suffix:
Gender:F
Credentials:CNA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:14256 ARBOR FOREST DR
Mailing Address - Street 2:
Mailing Address - City:ROCKVILLE
Mailing Address - State:MD
Mailing Address - Zip Code:20850-7477
Mailing Address - Country:US
Mailing Address - Phone:240-731-7930
Mailing Address - Fax:
Practice Address - Street 1:14256 ARBOR FOREST DR
Practice Address - Street 2:
Practice Address - City:ROCKVILLE
Practice Address - State:MD
Practice Address - Zip Code:20850-7477
Practice Address - Country:US
Practice Address - Phone:240-731-7930
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-08-25
Last Update Date:2020-08-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDM635135968123172A00000X
MDCNA20202111374U00000X, 376K00000X, 251E00000X
376J00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
No172A00000XOther Service ProvidersDriver
No374U00000XNursing Service Related ProvidersHome Health Aide
No376J00000XNursing Service Related ProvidersHomemaker
No376K00000XNursing Service Related ProvidersNurse's Aide