MEDICARE: MRS. SHADAE APRIL MARTINEZ 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
1	363LF0000X	Family Nurse Practitioner	1057521	TX
2	363L00000X	Nurse Practitioner	1057521	TX

General Provider Information

NPI Number	:	1558028134
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MRS. SHADAE APRIL MARTINEZ FNP-C

Provider Business Mailing Address
First Line	:	14917 LONG SHADOW AVE
Second Line	:
City	:	EL PASO
State	:	TX
Zip	:	79938-3193
Country	:	US
Telephone Number	:	210-430-8326
Fax Number	:

Provider Business Practice Location Address
First Line	:	121 E REDD RD
Second Line	:
City	:	EL PASO
State	:	TX
Zip	:	79932-1981
Country	:	US
Telephone Number	:	915-584-8884
Fax Number	:

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

Provider Enumeration Date	:	11/18/2021
Last Update Date	:	02/23/2023

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Directions to “ MRS. SHADAE APRIL MARTINEZ FNP-C” Practice Location

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