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General NPI Number Information
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NPI Number | 1104596360
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Entity Type | Individual
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Provider Name | BERTHA MARTINEZ NUNEZ FNP-C
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Gender | Female
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Dates
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Enumeration Date | 09/17/2021
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Last Update Date | 09/17/2021
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Provider Practice Location Address
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Address Line | 3415 N LOOP 250 W BLDG 4
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City | MIDLAND
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State | TX
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Zip | 79707-6034
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Country | US
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Telephone | 432-221-3300
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Fax | 432-221-3313
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Provider Business Mailing Address
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Address Line | 4214 ANDREWS HWY STE 240
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City | MIDLAND
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State | TX
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Zip | 79703-4817
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Country | US
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Telephone | 432-686-6605
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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 | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | 1040085
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License Number State | TX
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