Healthcare Provider Details

I. General information

NPI: 1205712973
Provider Name (Legal Business Name): BARBARA ELAINE MARTINEZ RNFA
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/15/2025
Last Update Date: 08/15/2025
Certification Date: 08/15/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1968 PEACHTREE RD NW
ATLANTA GA
30309-1281
US

IV. Provider business mailing address

407 HARRIS MANOR DR SW
ATLANTA GA
30311-2161
US

V. Phone/Fax

Practice location:
  • Phone: 404-605-5000
  • Fax:
Mailing address:
  • Phone: 404-326-1399
  • Fax: 404-326-1399

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163WR0006X
TaxonomyRegistered Nurse First Assistant
License NumberRN085520
License Number StateGA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: