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General NPI Number Information
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NPI Number | 1427779008
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Entity Type | Individual
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Provider Name | ADAM TYLER MARTIN APRN, FNP-C
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Gender | Male
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Dates
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Enumeration Date | 09/12/2022
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Last Update Date | 09/17/2024
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Provider Practice Location Address
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Address Line | 1265 S BROADWAY
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City | DENVER
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State | CO
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Zip | 80210-1503
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Country | US
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Telephone | 352-227-3341
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Fax |
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Provider Business Mailing Address
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Address Line | 4670 S HURON ST
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City | ENGLEWOOD
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State | CO
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Zip | 80110-5638
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Country | US
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Telephone | 689-213-7450
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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 | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | APRN11021768
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License Number State | FL
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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 | C-APN.0100385-C-NP
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License Number State | CO
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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 | APN.0999624-NP
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License Number State | CO
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