Healthcare Provider Details

I. General information

NPI: 1376796227
Provider Name (Legal Business Name): ERIN E. MARTINELL NP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: ERIN E MAKI NP

II. Dates (important events)

Enumeration Date: 10/23/2008
Last Update Date: 06/30/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

85 HERRICK ST
BEVERLY MA
01915-1790
US

IV. Provider business mailing address

85 HERRICK ST
BEVERLY MA
01915-1790
US

V. Phone/Fax

Practice location:
  • Phone: 978-927-6850
  • Fax: 978-524-7917
Mailing address:
  • Phone: 978-927-6850
  • Fax: 978-524-7917

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number258911
License Number StateMA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: