MEDICARE: DANIELLA NICOLE MARTINO 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	163W00000X	Registered Nurse	948125	TX

General Provider Information

NPI Number	:	1396231072
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DANIELLA NICOLE MARTINO RN

Provider Business Mailing Address
First Line	:	2902 FOREST POINT DR APT 2703
Second Line	:
City	:	ARLINGTON
State	:	TX
Zip	:	76006-3038
Country	:	US
Telephone Number	:	210-818-7679
Fax Number	:

Provider Business Practice Location Address
First Line	:	2902 FOREST POINT DR APT 2703
Second Line	:
City	:	ARLINGTON
State	:	TX
Zip	:	76006-3038
Country	:	US
Telephone Number	:	210-818-7679
Fax Number	:

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

Provider Enumeration Date	:	07/06/2018
Last Update Date	:	07/06/2018

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