Individual
NADINE MARTIN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NURSE PRACTITIONER
Contact information
Practice address
311 MAPLETON AVE # 331, BOULDER, CO 80304
(720) 289-0606
Mailing address
2000 21ST ST, BOULDER, CO 80302-4501
(720) 289-0606
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
405200
CA
363L00000X
Nurse Practitioner
7458
CA
363LA2200X
Adult Health Nurse Practitioner
Primary
APN.0993533-NP
CO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
405200
REGISTERED NURSE LICENSE
CA
01
—
APN.0993533-NP
COLORADO DIVISION OF REGULATED AGENCIES
CO
Enumeration date
06/08/2017
Last updated
08/20/2018
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