Individual
MRS. TANYA R MARTIN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
12001 Q ST, OMAHA, NE 68137-3542
(402) 592-0328
(402) 592-4170
Mailing address
12001 Q ST, OMAHA, NE 68137-3542
(402) 592-0328
(402) 592-4170
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
1932
NE
363AM0700X
Medical Physician Assistant
1932
NE
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
10025393900
—
NE
Enumeration date
07/16/2012
Last updated
01/09/2026
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