Individual
CAROL A MARTENEY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
CRNA
Contact information
Practice address
405 GRAND AVE, DAYTON, OH 45405-4720
(937) 723-5863
(937) 723-5109
Mailing address
PO BOX 711131, CINCINNATI, OH 45271-1131
(937) 293-0247
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
017996
WV
367500000X
Certified Registered Nurse Anesthetist
Primary
COA.04237-NA
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0856542
—
OH
05
—
2603263000
—
WV
01
—
P00789301
RAILROAD MEDICARE - MHCPI
OH
Enumeration date
07/18/2006
Last updated
05/20/2014
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