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General NPI Number Information
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NPI Number | 1053076554
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Entity Type | Individual
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Provider Name | MARTA PACHECO
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Gender | Female
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Dates
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Enumeration Date | 11/01/2021
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Last Update Date | 01/15/2024
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Provider Practice Location Address
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Address Line | 1617 SHETLAND LN
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City | ROCK HILL
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State | SC
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Zip | 29730-4998
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Country | US
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Telephone | 540-797-4361
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Fax |
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Provider Business Mailing Address
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Address Line | 1617 SHETLAND LN
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City | ROCK HILL
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State | SC
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Zip | 29730-4998
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Country | US
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Telephone | 540-797-4361
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363LA2100X
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Taxonomy Name | Acute Care Nurse Practitioner
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License Number | 2000319019
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License Number State | NC
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Taxonomy #2
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Taxonomy Code | 363LA2100X
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Taxonomy Name | Acute Care Nurse Practitioner
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License Number | 0024189006
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License Number State | VA
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