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General NPI Number Information
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NPI Number | 1538213236
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Entity Type | Individual
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Provider Name | LETICIA VEHEMENTE MARTINEZ NANDA MS, CRNP
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Gender | Female
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Dates
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Enumeration Date | 01/22/2007
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | 5510 NATHAN SHOCK DR
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City | BALTIMORE
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State | MD
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Zip | 21224-6823
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Country | US
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Telephone | 410-550-0047
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Fax |
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Provider Business Mailing Address
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Address Line | 4915 WILLSHIRE AVE
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City | BALTIMORE
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State | MD
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Zip | 21206-4329
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Country | US
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Telephone | 410-485-2910
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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 | 363LA2200X
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Taxonomy Name | Adult Health Nurse Practitioner
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License Number | R052381
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License Number State | MD
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