MEDICARE: LUCY ELIZABETH MARTIN

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	363L00000X	Nurse Practitioner	C-APN.0003262-C-NP	CO
2	363LP0200X	Pediatric Nurse Practitioner	24978	TN
3	163W00000X	Registered Nurse	225374	TN

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	C-APN.0003262-C-NP	OTHER	CO	NP

General Provider Information

NPI Number	:	1912472564
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	LUCY ELIZABETH MARTIN

Provider Business Mailing Address
First Line	:	290 W ALAMEDA AVE APT 343
Second Line	:
City	:	DENVER
State	:	CO
Zip	:	80223-2182
Country	:	US
Telephone Number	:	615-881-6138
Fax Number	:

Provider Business Practice Location Address
First Line	:	6031 E WOODMEN RD STE 330
Second Line	:
City	:	COLORADO SPRINGS
State	:	CO
Zip	:	80923-2624
Country	:	US
Telephone Number	:	719-638-1122
Fax Number	:

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

Provider Enumeration Date	:	10/10/2018
Last Update Date	:	12/03/2025

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Directions to “ LUCY ELIZABETH MARTIN ” Practice Location

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