Healthcare Provider Details

I. General information

NPI: 1306474275
Provider Name (Legal Business Name): IRENE MARIE MARTINEZ RN
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 03/27/2020
Last Update Date: 03/27/2025
Certification Date: 03/27/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7401 DEER WOOD ST
UNION CITY GA
30291-1173
US

IV. Provider business mailing address

7401 DEER WOOD ST
UNION CITY GA
30291-1173
US

V. Phone/Fax

Practice location:
  • Phone: 714-349-2128
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code174H00000X
TaxonomyHealth Educator
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code374J00000X
TaxonomyDoula
License Number
License Number State
# 3
Primary TaxonomyY
Taxonomy Code163WN0002X
TaxonomyNeonatal Intensive Care Registered Nurse
License NumberRN260195
License Number StateGA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: