MEDICARE: MS. MARTHA JEAN GOETZ FNP

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	363LF0000X	Family Nurse Practitioner	263300970	WY
2	363L00000X	Nurse Practitioner	4704214400	MI

General Provider Information

NPI Number	:	1538260856
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MS. MARTHA JEAN GOETZ FNP

Provider Business Mailing Address
First Line	:	2230 E MITCHELL RD STE A
Second Line	:
City	:	PETOSKEY
State	:	MI
Zip	:	49770-6601
Country	:	US
Telephone Number	:	231-622-8103
Fax Number	:	949-695-2102

Provider Business Practice Location Address
First Line	:	2230 E MITCHELL RD STE A
Second Line	:
City	:	PETOSKEY
State	:	MI
Zip	:	49770-6601
Country	:	US
Telephone Number	:	231-622-8103
Fax Number	:

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

Provider Enumeration Date	:	09/26/2006
Last Update Date	:	03/03/2026

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