Provider Demographics
NPI:1932740651
Name:MARTINEZ, MARIA MYERS (NP)
Entity Type:Individual
Prefix:
First Name:MARIA
Middle Name:MYERS
Last Name:MARTINEZ
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1105 N 500 W
Mailing Address - Street 2:ATTEN CREDENTIALING
Mailing Address - City:PROVO
Mailing Address - State:UT
Mailing Address - Zip Code:84604-2475
Mailing Address - Country:US
Mailing Address - Phone:018-354-8225
Mailing Address - Fax:801-418-0941
Practice Address - Street 1:996 E 70 S
Practice Address - Street 2:
Practice Address - City:AMERICAN FORK
Practice Address - State:UT
Practice Address - Zip Code:84003-2475
Practice Address - Country:US
Practice Address - Phone:801-360-9915
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-10-03
Last Update Date:2021-03-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
UT314781-3102363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily