MEDICARE: REBECCA ANN MARTENS 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	18999	TN
2	163WX0002X	High-Risk Obstetric Registered Nurse	RN0000136799	TN

General Provider Information

NPI Number	:	1760899645
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	REBECCA ANN MARTENS FNP

Provider Business Mailing Address
First Line	:	PO BOX 40549
Second Line	:
City	:	BELFAST
State	:	ME
Zip	:	04915-1256
Country	:	US
Telephone Number	:	904-281-1915
Fax Number	:	904-281-1119

Provider Business Practice Location Address
First Line	:	5011 GATE PKWY BLDG 100
Second Line	:
City	:	JACKSONVILLE
State	:	FL
Zip	:	32256-0830
Country	:	US
Telephone Number	:	904-281-1915
Fax Number	:	904-281-1119

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

Provider Enumeration Date	:	07/12/2014
Last Update Date	:	02/20/2026

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