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General NPI Number Information
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NPI Number | 1700699329
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Entity Type | Individual
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Provider Name | NINA G MARTYNENKO RN
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Gender | Female
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Dates
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Enumeration Date | 01/28/2025
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Last Update Date | 01/28/2025
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Provider Practice Location Address
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Address Line | 22820 E APPLEWAY AVE STE A
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City | LIBERTY LAKE
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State | WA
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Zip | 99019-5214
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Country | US
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Telephone | 509-473-4900
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Fax |
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Provider Business Mailing Address
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Address Line | 3427 N LEE ST
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City | SPOKANE
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State | WA
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Zip | 99207-4664
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Country | US
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Telephone | 509-473-4900
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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 | 163WH0200X
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Taxonomy Name | Home Health Registered Nurse
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License Number | RN00176324
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License Number State | WA
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