Individual
DIANE MARTIN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RN
Contact information
Practice address
8081 INNOVATION PARK DR. 5TH FLOOR, FAIRFAX, VA 22031
(571) 472-1646
(571) 472-7037
Mailing address
8081 INNOVATION PARK DR. 5TH FLOOR, FAIRFAX, VA 22031
(571) 472-1646
(571) 472-7037
Taxonomy
Speciality
Code
Description
License number
State
163WP2201X
Ambulatory Care Registered Nurse
0001229190
VA
163WU0100X
Urology Registered Nurse
Primary
0001229190
VA
163WX0800X
Orthopedic Registered Nurse
0001229190
VA
Other
Enumeration date
08/14/2023
Last updated
08/14/2023
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