Healthcare Provider Details

I. General information

NPI: 1467573444
Provider Name (Legal Business Name): MONIQUE M MARTEL NP
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 04/03/2007
Last Update Date: 01/31/2020
Certification Date: 01/31/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7261 S BROADWAY STE 101B
LITTLETON CO
80122-8017
US

IV. Provider business mailing address

7261 S BROADWAY STE 101B
LITTLETON CO
80122-8017
US

V. Phone/Fax

Practice location:
  • Phone: 303-788-0980
  • Fax: 303-788-0806
Mailing address:
  • Phone: 303-788-0980
  • Fax: 303-788-0806

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number58173
License Number StateCO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: