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General NPI Number Information
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NPI Number | 1255683140
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Entity Type | Individual
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Provider Name | MARTIN ROCO FNP
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Gender | Male
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Dates
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Enumeration Date | 10/03/2012
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Last Update Date | 08/28/2024
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Provider Practice Location Address
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Address Line | 1141 PEAR TREE LN
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City | NAPA
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State | CA
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Zip | 94558-6484
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Country | US
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Telephone | 707-254-1770
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Fax |
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Provider Business Mailing Address
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Address Line | 3325 JEFFERSON ST # 1116
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City | NAPA
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State | CA
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Zip | 94558-3437
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Country | US
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Telephone | 562-607-8888
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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 | 005192
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License Number State | CT
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Taxonomy #2
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Taxonomy Code | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | 201500803NP-PP
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License Number State | OR
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Taxonomy #3
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Taxonomy Code | 363LP2300X
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Taxonomy Name | Primary Care Nurse Practitioner
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License Number | NP95027617
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License Number State | CA
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