Healthcare Provider Details

I. General information

NPI: 1154090439
Provider Name (Legal Business Name): MARIBEL MARTINEZ RN
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/09/2021
Last Update Date: 08/06/2026
Certification Date: 08/06/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

121 TULIP LN
EWING NJ
08638-2023
US

IV. Provider business mailing address

121 TULIP LN
EWING NJ
08638-2023
US

V. Phone/Fax

Practice location:
  • Phone: 609-433-2262
  • Fax:
Mailing address:
  • Phone: 609-433-2262
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License Number26NJ01223700
License Number StateNJ
# 2
Primary TaxonomyN
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License Number26NR15986500
License Number StateNJ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: