Individual
PATRICIA MARTINEZ
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
RN, MSN, FNP-BC
Contact information
Practice address
4604 N PENNGROVE WAY # 100, MERIDIAN, ID 83646-7442
(208) 992-3324
Mailing address
15449 GOODSON RD, CALDWELL, ID 83607-8406
(208) 447-0526
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
53550
ID
363LF0000X
Family Nurse Practitioner
Primary
53550
ID
Other
Enumeration date
02/08/2023
Last updated
12/09/2024
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