Healthcare Provider Details

I. General information

NPI: 1225400682
Provider Name (Legal Business Name): CHERYL ANN MARTINEZ MS, RN, OCN, CHPN
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 10/26/2015
Last Update Date: 01/05/2023
Certification Date: 01/05/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

65 INTERNATIONAL DRIVE
GREENVILLE SC
29615
US

IV. Provider business mailing address

300 E MCBEE AVE FL 4
GREENVILLE SC
29601-2842
US

V. Phone/Fax

Practice location:
  • Phone: 864-987-7000
  • Fax:
Mailing address:
  • Phone: 864-522-8603
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207RX0202X
TaxonomyMedical Oncology Physician
License Number23481
License Number StateSC
# 2
Primary TaxonomyY
Taxonomy Code363LA2100X
TaxonomyAcute Care Nurse Practitioner
License Number23481
License Number StateSC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: