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NPI Code Detail

MEDICARE: SAMANTHA LYNN MARTINEZ CNM, DNP

MEDICARE: SAMANTHA LYNN MARTINEZ CNM, DNP
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
1367A00000XAdvanced Practice Midwife1124174TX

General Provider Information

NPI Number : 1356181002
Entity Type Code : Individual
Provider Name (Legal Business Name) : SAMANTHA LYNN MARTINEZ CNM, DNP
Provider Business Mailing Address
First Line : 928 DOVE CV
Second Line :
City : NORTHLAKE
State : TX
Zip : 76226-1982
Country : US
Telephone Number : 509-679-8074
Fax Number :
Provider Business Practice Location Address
First Line : 411 N WASHINGTON AVE STE 2700
Second Line :
City : DALLAS
State : TX
Zip : 75246-1735
Country : US
Telephone Number : 214-975-3937
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 05/30/2024
Last Update Date : 06/19/2024

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