MEDICARE: CIARA MARTINEZ RN, IBCLC

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	163WL0100X	Lactation Consultant (Registered Nurse)	1679740	CO

General Provider Information

NPI Number	:	1962351692
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	CIARA MARTINEZ RN, IBCLC

Provider Business Mailing Address
First Line	:	1149 ANKER DR
Second Line	:
City	:	ERIE
State	:	CO
Zip	:	80516-9098
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	1149 ANKER DR
Second Line	:
City	:	ERIE
State	:	CO
Zip	:	80516-9098
Country	:	US
Telephone Number	:	931-561-6164
Fax Number	:

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

Provider Enumeration Date	:	01/26/2026
Last Update Date	:	01/26/2026

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