Individual
MRS. WALLIS H MARTZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NP
Contact information
Practice address
2339 MCCALLIE AVE, SUITE 309, CHATTANOOGA, TN 37404-3256
(423) 698-0850
(423) 698-0511
Mailing address
2339 MCCALLIE AVE, SUITE 309, CHATTANOOGA, TN 37404-3256
(423) 698-0850
(423) 698-0511
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
50413
TN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
33491821
—
TN
01
—
4156507
TENNESSEE BCBS
TN
01
—
P00435620
RAILROAD MEDICARE
TN
Enumeration date
07/19/2005
Last updated
08/17/2011
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