Healthcare Provider Details

I. General information

NPI: 1902262611
Provider Name (Legal Business Name): MARIAH STONE MARTIN BSN, MSN, ACNP-BC
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: MARIAH STONE MARTIN BSN, MSN, ACNP-BC

II. Dates (important events)

Enumeration Date: 01/11/2016
Last Update Date: 05/09/2024
Certification Date: 05/09/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

777 BANNOCK ST # MC3240
DENVER CO
80204-4597
US

IV. Provider business mailing address

777 BANNOCK ST
DENVER CO
80204-4597
US

V. Phone/Fax

Practice location:
  • Phone: 303-436-6000
  • Fax:
Mailing address:
  • Phone: 303-602-3899
  • Fax: 303-602-3902

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code363LA2100X
TaxonomyAcute Care Nurse Practitioner
License NumberARNP93581071
License Number StateFL
# 2
Primary TaxonomyN
Taxonomy Code363LA2100X
TaxonomyAcute Care Nurse Practitioner
License NumberAP60594755
License Number StateWA
# 3
Primary TaxonomyN
Taxonomy Code363LA2100X
TaxonomyAcute Care Nurse Practitioner
License NumberRN288825
License Number StateGA
# 4
Primary TaxonomyN
Taxonomy Code363LA2100X
TaxonomyAcute Care Nurse Practitioner
License NumberAP122907
License Number StateTX
# 5
Primary TaxonomyY
Taxonomy Code363LA2100X
TaxonomyAcute Care Nurse Practitioner
License NumberC-APN.0100661-C-NP
License Number StateCO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: