MEDICARE: MARTA E ARTIGA RN

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
1	163WC1600X	Continuing Education/Staff Development Registered Nurse	61412	CA

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	61412	OTHER	CA	RN LICENSE

General Provider Information

NPI Number	:	1174553150
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MARTA E ARTIGA RN

Provider Business Mailing Address
First Line	:	1250 BARSTOW RD
Second Line	:	APT 25
City	:	BARSTOW
State	:	CA
Zip	:	92311-4988
Country	:	US
Telephone Number	:	323-314-6156
Fax Number	:

Provider Business Practice Location Address
First Line	:	4TH AND INNER LOOP
Second Line	:	BUILDING 166
City	:	FORT IRWIN
State	:	CA
Zip	:	92310-5109
Country	:	US
Telephone Number	:	760-380-5226
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	07/04/2006
Last Update Date	:	07/08/2007

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