Healthcare Provider Details

I. General information

NPI: 1023214251
Provider Name (Legal Business Name): RITA MARIE RHOADS MARTINEZ CRNP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/25/2007
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1138 GEORGETOWN ROAD
BART PA
17503-0152
US

IV. Provider business mailing address

200 W 4TH ST
QUARRYVILLE PA
17566-1123
US

V. Phone/Fax

Practice location:
  • Phone: 717-786-5506
  • Fax: 717-786-5507
Mailing address:
  • Phone: 717-786-3406
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberSP000162B
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: