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General NPI Number Information
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NPI Number | 1710864566
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Entity Type | Individual
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Provider Name | JESSICA ELAINE MARTINEZ RN
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Gender | Female
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Dates
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Enumeration Date | 08/21/2025
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Last Update Date | 08/21/2025
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Provider Practice Location Address
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Address Line | 3800 ULM NORTH FRONTAGE RD
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City | GREAT FALLS
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State | MT
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Zip | 59404-5574
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Country | US
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Telephone | 406-454-6822
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Fax | 406-454-6942
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Provider Business Mailing Address
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Address Line | 719 8TH AVE N
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City | GREAT FALLS
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State | MT
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Zip | 59401-1033
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Country | US
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Telephone | 406-390-4013
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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 | 163WG0000X
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Taxonomy Name | General Practice Registered Nurse
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License Number | RN-131105
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License Number State | MT
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