Individual
CRYSTAL MARTINEZ
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
NP
Contact information
Practice address
3151 DALLAS HIGH SHOALS HWY UNIT 935, DALLAS, NC 28034-1369
(803) 470-5358
Mailing address
3151 DALLAS HIGH SHOALS HWY UNIT 935, DALLAS, NC 28034-1369
(803) 470-5358
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
289876
NC
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
5011600
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
F0290156
—
NC
Enumeration date
02/05/2019
Last updated
09/09/2022
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