MEDICARE: LENDELL MARTIN

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	363LP0808X	Psychiatric/Mental Health Nurse Practitioner	RN170362	AZ

General Provider Information

NPI Number	:	1861355836
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	LENDELL MARTIN

Provider Business Mailing Address
First Line	:	2841 N CASTRO AVE
Second Line	:
City	:	TUCSON
State	:	AZ
Zip	:	85705-4453
Country	:	US
Telephone Number	:
Fax Number	:	602-441-1739

Provider Business Practice Location Address
First Line	:	2841 N CASTRO AVE
Second Line	:
City	:	TUCSON
State	:	AZ
Zip	:	85705-4453
Country	:	US
Telephone Number	:	480-332-5503
Fax Number	:	602-441-1739

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	12/06/2025
Last Update Date	:	05/26/2026

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Directions to “ LENDELL MARTIN ” Practice Location

Language	Start Address	Practice Location

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