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General NPI Number Information
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NPI Number | 1720813587
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Entity Type | Individual
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Provider Name | SONGHUI MARTIN RN, PA
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Gender | Female
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Dates
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Enumeration Date | 09/03/2024
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Last Update Date | 11/15/2025
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Provider Practice Location Address
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Address Line | 5420 N DOLAN CT
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City | PRESCOTT VALLEY
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State | AZ
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Zip | 86314-6753
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Country | US
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Telephone | 626-464-4379
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Fax |
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Provider Business Mailing Address
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Address Line | 5420 N DOLAN CT
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City | PRESCOTT VALLEY
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State | AZ
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Zip | 86314-6753
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Country | US
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Telephone | 626-464-4379
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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 | 163W00000X
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Taxonomy Name | Registered Nurse
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License Number | 729174
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License Number State | CA
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Taxonomy #2
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Taxonomy Code | 363A00000X
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Taxonomy Name | Physician Assistant
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License Number | 002239-PA
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License Number State | PR
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Taxonomy #3
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Taxonomy Code | 163W00000X
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Taxonomy Name | Registered Nurse
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License Number | 255309
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License Number State | AZ
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