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General NPI Number Information
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NPI Number | 1366162067
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Entity Type | Individual
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Provider Name | MICHELLE MARTZ FNP
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Gender | Female
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Dates
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Enumeration Date | 09/01/2022
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Last Update Date | 05/24/2024
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Provider Practice Location Address
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Address Line | 1940 WESTLAND DR SW
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City | CLEVELAND
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State | TN
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Zip | 37311-8102
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Country | US
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Telephone | 914-364-6857
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Fax |
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Provider Business Mailing Address
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Address Line | 12607 MYRTLE RIDGE LN
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City | KNOXVILLE
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State | TN
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Zip | 37932-2738
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Country | US
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Telephone |
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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 | 35599
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License Number State | TN
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Taxonomy #2
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Taxonomy Code | 163W00000X
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Taxonomy Name | Registered Nurse
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License Number | 275908
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License Number State | TN
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Taxonomy #3
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Taxonomy Code | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | APRN11021657
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License Number State | FL
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