Katrina Martinez, PMHNP

Individual provider Active NPI Psychiatric/Mental Health Nurse Practitioner · Moseley, VA

NPI 1013307149 · NPPES record last updated Nov 20, 2020

Key facts

NPI
1013307149
Entity type
Individual (NPI type 1)
Primary specialty
Psychiatric/Mental Health Nurse Practitioner 363LP0808X
License
AP60691531 (WA)
Practice address
11913 Black Alder Dr
Moseley, VA 23120-1582
Phone
(619) 241-0333
NPI assigned
Jan 27, 2015
Sex
Female
Sole proprietor
No

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No

State licenses

LicenseStateTypeSpecialty
616002CAMDRegistered Nurse
AP60691531WAMDPsychiatric/Mental Health Nurse Practitioner

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Nurse 163W00000X 616002 CA
Psychiatric/Mental Health Nurse Practitioner 363LP0808X AP60691531 WA Yes

Addresses

Primary practice location

11913 Black Alder Dr
Moseley, VA 23120-1582

Mailing address

700 24TH St
Fort Lee, VA 23801-1716

Other providers in Moseley, VA

All providers in Moseley, VA · Psychiatric/Mental Health Nurse Practitioner in Virginia

Sources for this page

Verify at the official NPI Registry.