Individual
MS. ANDIE JENNIFFER MARTINEZ WATROUS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
FNP-BC
Contact information
Practice address
2315 STOCKTON BLVD, SACRAMENTO, CA 95817-2201
(916) 734-2111
Mailing address
1361 ALLEN AVE, GLENDALE, CA 91201-1105
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
661053
NY
163W00000X
Registered Nurse
847353
CA
363L00000X
Nurse Practitioner
Primary
95006587
CA
Other
Enumeration date
07/13/2013
Last updated
01/28/2020
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