Individual
MARTIN TAXERA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
R.N.
Contact information
Practice address
500 N INDIANA AVE., WINSLOW, AZ 86047-2169
(928) 289-6197
Mailing address
1630 W UNIVERSITY HEIGHTS DR S, FLAGSTAFF, AZ 86001-9138
(928) 225-9495
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
Primary
725877
CA
Other
Enumeration date
12/21/2010
Last updated
11/13/2012
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