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General NPI Number Information
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NPI Number | 1720235864
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Entity Type | Individual
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Provider Name | SALLY TEADT MARTINEZ FNP-BC, DNP
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Gender | Female
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Dates
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Enumeration Date | 08/20/2008
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Last Update Date | 12/17/2025
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Provider Practice Location Address
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Address Line | 110 E PARK AVE
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City | CHIEFLAND
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State | FL
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Zip | 32626-0901
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Country | US
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Telephone | 352-339-8981
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Fax | 352-754-3305
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Provider Business Mailing Address
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Address Line | 110 E PARK AVE
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City | CHIEFLAND
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State | FL
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Zip | 32626-0901
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Country | US
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Telephone | 352-339-8981
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Fax | 352-754-3305
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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 | 163WP0807X
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Taxonomy Name | Child & Adolescent Psychiatric/Mental Health Registered Nurse
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License Number | ARNP2745582
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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 | ARNP2745582
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License Number State | FL
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