Individual
MRS. TAMEKA TRENDA MARTIN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
FNP-C, AGACNP-BC
Contact information
Practice address
501 SAUNDERS AVE STE 300, TYLER, TX 75702-7524
(903) 579-9800
Mailing address
PO BOX 911230, DALLAS, TX 75391-1230
(972) 997-8000
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
AP136241
TX
363LA2100X
Acute Care Nurse Practitioner
Primary
AP136241
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
382699201
—
TX
01
—
642399YMAF
MEDICARE
TX
01
—
8JF321
BCBS
TX
01
—
P02026182
MEDICARE RAIL ROAD
TX
Enumeration date
03/19/2018
Last updated
11/26/2024
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