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General NPI Number Information
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NPI Number | 1932439205
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Entity Type | Individual
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Provider Name | LATRICE DIANN MARTIN DNP
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Gender | Female
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Dates
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Enumeration Date | 01/07/2010
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Last Update Date | 08/26/2025
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Provider Practice Location Address
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Address Line | 401 E GOLD COAST RD STE 340
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City | PAPILLION
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State | NE
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Zip | 68046-4131
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Country | US
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Telephone | 402-884-9059
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Fax | 833-875-0053
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Provider Business Mailing Address
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Address Line | 909 N ADAMS ST UNIT 460700
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City | PAPILLION
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State | NE
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Zip | 68046-3078
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Country | US
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Telephone |
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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 | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | A126762
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License Number State | IA
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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 | 112220
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License Number State | NE
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Taxonomy #3
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Taxonomy Code | 363LP0808X
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Taxonomy Name | Psychiatric/Mental Health Nurse Practitioner
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License Number | G170270
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License Number State | IA
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Taxonomy #4
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Taxonomy Code | 363LP0808X
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Taxonomy Name | Psychiatric/Mental Health Nurse Practitioner
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License Number | 112220
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License Number State | NE
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Taxonomy #5
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Taxonomy Code | 367A00000X
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Taxonomy Name | Advanced Practice Midwife
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License Number | 120042
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License Number State | NE
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Taxonomy #6
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Taxonomy Code | 367A00000X
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Taxonomy Name | Advanced Practice Midwife
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License Number | B-126762
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License Number State | IA
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Taxonomy #7
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Taxonomy Code | 363L00000X
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Taxonomy Name | Nurse Practitioner
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License Number | 112220
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License Number State | NE
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