MEDICARE: MRS. ROBIN LYNN MARTIN CRNA

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	367500000X	Certified Registered Nurse Anesthetist	0024166064	VA

General Provider Information

NPI Number	:	1962480285
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MRS. ROBIN LYNN MARTIN CRNA

Provider Business Mailing Address
First Line	:	7227 HORIZON OAKS
Second Line	:
City	:	SAN ANTONIO
State	:	TX
Zip	:	78244-1754
Country	:	US
Telephone Number	:	757-675-0003
Fax Number	:

Provider Business Practice Location Address
First Line	:	36065 SANTA FE AVE
Second Line	:
City	:	FORT HOOD
State	:	TX
Zip	:	76544-5060
Country	:	US
Telephone Number	:	254-288-8000
Fax Number	:

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

Provider Enumeration Date	:	01/06/2006
Last Update Date	:	07/09/2021

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