Healthcare Provider Details

I. General information

NPI: 1841327418
Provider Name (Legal Business Name): DULLINE V MARTINEZ
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 02/28/2007
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2500 S HAVANA ST
AURORA CO
80014-1618
US

IV. Provider business mailing address

25897 E CANAL PL
AURORA CO
80018
US

V. Phone/Fax

Practice location:
  • Phone: 303-338-3274
  • Fax:
Mailing address:
  • Phone: 303-364-7168
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code376K00000X
TaxonomyNurse's Aide
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: