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General NPI Number Information
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NPI Number | 1982411161
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Entity Type | Organization
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Legal Business Name | MARTENS MEDICAL PLLC
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Dates
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Enumeration Date | 12/12/2024
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Last Update Date | 01/14/2025
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Provider Practice Location Address
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Address Line | 334 E 200 S
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City | BURLEY
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State | ID
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Zip | 83318-5433
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Country | US
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Telephone | 208-260-0961
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Fax |
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Provider Business Mailing Address
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Address Line | 334 E 200 S
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City | BURLEY
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State | ID
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Zip | 83318-5433
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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 | MEDICAL DIRECTOR
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Name | MRS. KAY MARTENS
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Credential | FNP-C, PMHNP-BC
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Telephone | 208-260-0961
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QM0801X
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Taxonomy Name | Mental Health Clinic/Center (Including Community Mental Health Center)
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 261QP2300X
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Taxonomy Name | Primary Care Clinic/Center
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License Number |
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License Number State |
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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 |
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License Number State |
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