Cynthia (Cindy) M Martin, RN
Individual provider Active NPI Registered Nurse · Aztec, NM
NPI 1164029252 · NPPES record last updated Oct 2, 2020
Key facts
- NPI
- 1164029252
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Registered Nurse 163W00000X
- License
- R34985 (NM)
- Practice address
- 401 Rio Pecos Rd
Aztec, NM 87410-1646 - Phone
- (505) 334-2621
- Fax
- (505) 599-4391
- NPI assigned
- Oct 2, 2020
- Sex
- Female
- Sole proprietor
- Yes
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
- Credentials
- Registered Nurse
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| R34985 | NM | MD | Registered Nurse |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Registered Nurse | 163W00000X | R34985 | NM | Yes |
Addresses
Primary practice location
401 Rio Pecos Rd
Aztec, NM 87410-1646
Mailing address
Exceptional Program Office, 1118 W. Aztec Blvd.
Aztec, NM 87410
Phone (505) 334-3695
Other practice location 1
455 N Light Plant Rd
Aztec, NM 87410-1517
Phone (505) 334-6102
Other practice location 2
1180 W Aztec Blvd
Aztec, NM 87410-1818
Phone (505) 334-9474
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1919 | Medicaid | NM |
Other providers in Aztec, NM
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Oct 2, 2020. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.