Individual
MARYANNE MARTINEZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
R.N.
Contact information
Practice address
233 MAIN STREET, SUITE C, SAN LUIS, CO 81152
(719) 672-3332
(719) 672-3856
Mailing address
PO BOX 99, SAN LUIS, CO 81152-0099
(719) 672-3332
(719) 672-3856
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
Primary
RN-104428
CO
Other
Enumeration date
05/03/2012
Last updated
05/03/2012
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