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NPI Code Detail

MEDICARE: CAREY LYNN MARTIN CRNA

MEDICARE: CAREY LYNN MARTIN CRNA
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1367500000XCertified Registered Nurse Anesthetist39484TX

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
280224COTHERTXBC/BS

General Provider Information

NPI Number : 1003899139
Entity Type Code : Individual
Provider Name (Legal Business Name) : CAREY LYNN MARTIN CRNA
Provider Business Mailing Address
First Line : 3100 TONGASS AVE
Second Line :
City : KETCHIKAN
State : AK
Zip : 99901-5746
Country : US
Telephone Number : 907-228-7634
Fax Number : 907-228-8332
Provider Business Practice Location Address
First Line : 3100 TONGASS AVE
Second Line :
City : KETCHIKAN
State : AK
Zip : 99901-5746
Country : US
Telephone Number : 907-228-7634
Fax Number : 907-228-8332
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 11/22/2005
Last Update Date : 06/16/2010

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Directions to “ CAREY LYNN MARTIN CRNA” Practice Location

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