Healthcare Provider Details

I. General information

NPI: 1033482062
Provider Name (Legal Business Name): ERIN MARIE MARTINEZ R.N.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 02/22/2012
Last Update Date: 05/22/2024
Certification Date: 05/22/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5601 TIERRA VIVA PL NW
ALBUQUERQUE NM
87107
US

IV. Provider business mailing address

5601 TIERRA VIVA PL NW
ALBUQUERQUE NM
87107-5233
US

V. Phone/Fax

Practice location:
  • Phone: 505-681-5607
  • Fax:
Mailing address:
  • Phone: 505-681-5607
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163WM0705X
TaxonomyMedical-Surgical Registered Nurse
License NumberR25289
License Number StateNM

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: