Individual
NICOLE R MARTINEZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
REGISTERED NURSE
Contact information
Practice address
925 BEVINS CT, LAKEPORT, CA 95453-9754
(707) 263-8382
Mailing address
19863 MOUNTAIN MDW S, HIDDEN VALLEY LAKE, CA 95467-8570
(707) 472-1309
Taxonomy
Speciality
Code
Description
License number
State
163WC1600X
Continuing Education/Staff Development Registered Nurse
95382888
CA
163WD0400X
Diabetes Educator Registered Nurse
95382888
CA
163WG0000X
General Practice Registered Nurse
Primary
95382888
CA
Other
Enumeration date
03/11/2025
Last updated
03/11/2025
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