Provider Demographics
NPI:1780408468
Name:MARTIAN, MERNA ANNE
Entity type:Individual
Prefix:
First Name:MERNA
Middle Name:ANNE
Last Name:MARTIAN
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 1:4876 SAN PABLO CT
Mailing Address - Street 2:
Mailing Address - City:NAPLES
Mailing Address - State:FL
Mailing Address - Zip Code:34109-3383
Mailing Address - Country:US
Mailing Address - Phone:239-298-1118
Mailing Address - Fax:
Practice Address - Street 1:4876 SAN PABLO CT
Practice Address - Street 2:
Practice Address - City:NAPLES
Practice Address - State:FL
Practice Address - Zip Code:34109-3383
Practice Address - Country:US
Practice Address - Phone:239-298-1118
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-11-11
Last Update Date:2024-11-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL2228412163WC0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WC0400XNursing Service ProvidersRegistered NurseCase Management