Healthcare Provider Details

I. General information

NPI: 1023119658
Provider Name (Legal Business Name): MARIA OLIVIA MARTINEZ RNC WHNP
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/26/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

260 S KIPLING ST
LAKEWOOD CO
80226-1086
US

IV. Provider business mailing address

6728 S ROBB ST
LITTLETON CO
80127-4946
US

V. Phone/Fax

Practice location:
  • Phone: 303-239-7172
  • Fax: 303-239-7088
Mailing address:
  • Phone: 303-973-7782
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LW0102X
TaxonomyWomen's Health Nurse Practitioner
License Number101537
License Number StateCO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: