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NPI Code Detail

MEDICARE: DR. LATONYA MARTIN DNP, NM, FNP-C

MEDICARE: DR. LATONYA MARTIN DNP, NM, FNP-C
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
1363LF0000XFamily Nurse Practitioner19124OH
2176B00000XMidwife07645OH

General Provider Information

NPI Number : 1215002142
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. LATONYA MARTIN DNP, NM, FNP-C
Provider Business Mailing Address
First Line : 4773 EAST 93RD STREET
Second Line :
City : GARFIELD HEIGHTS
State : OH
Zip : 44125
Country : US
Telephone Number : 216-773-6839
Fax Number :
Provider Business Practice Location Address
First Line : 9302 OLDE 8 RD
Second Line :
City : NORTHFIELD
State : OH
Zip : 44067-2027
Country : US
Telephone Number : 866-389-2727
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 11/24/2006
Last Update Date : 12/27/2021

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