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General NPI Number Information
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NPI Number | 1326801358
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Entity Type | Individual
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Provider Name | HARRY NELSON BROWN MARTINEZ APRN
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Gender | Male
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Dates
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Enumeration Date | 02/01/2024
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Last Update Date | 02/01/2024
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Provider Practice Location Address
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Address Line | 7101 YORKTOWN RD
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City | LOUISVILLE
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State | KY
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Zip | 40214-4940
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Country | US
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Telephone | 502-403-6272
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Fax |
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Provider Business Mailing Address
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Address Line | 7101 YORKTOWN RD APT 4
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City | LOUISVILLE
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State | KY
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Zip | 40214-4940
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Country | US
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Telephone | 502-403-6272
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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 | 363LG0600X
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Taxonomy Name | Gerontology Nurse Practitioner
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License Number | 3019134
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License Number State | KY
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