Individual
GERISE M. MARTINEZ
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
RNFA
Contact information
Practice address
8955 N 1000W RD, MANTENO, IL 60950-3587
(815) 468-3648
Mailing address
8955 N 1000W RD, MANTENO, IL 60950-3587
(815) 468-3648
Taxonomy
Speciality
Code
Description
License number
State
163WR0006X
Registered Nurse First Assistant
Primary
041295350
IL
Other
Enumeration date
03/23/2009
Last updated
03/23/2009
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