Vivian D. Martinez, LPN

Primary specialty

Licensed Practical NurseTaxonomy code 164W00000X

License

055791 Issued in MO

Practice address

Highway 191 & Hospital Road
Chinle Comprehensive Health Care Facility
Chinle, AZ 86503

Phone

(928) 674-7205

Fax

(928) 674-7705

NPI assigned

Nov 30, 2010

Last updated

Nov 30, 2010By the provider in NPPES

Sex

Female

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1291075200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1291075200000",
    "number": "1316249147",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "P.O. DRAWER PH",
            "address_2": "CHINLE COMPREHENSIVE HEALTH CARE FACILITY",
            "city": "CHINLE",
            "state": "AZ",
            "postal_code": "86503",
            "telephone_number": "928-674-7205",
            "fax_number": "928-674-7705"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "HIGHWAY 191 & HOSPITAL ROAD",
            "address_2": "CHINLE COMPREHENSIVE HEALTH CARE FACILITY",
            "city": "CHINLE",
            "state": "AZ",
            "postal_code": "86503",
            "telephone_number": "928-674-7205",
            "fax_number": "928-674-7705"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MARTINEZ",
        "first_name": "VIVIAN",
        "middle_name": "D.",
        "credential": "LPN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2010-11-30",
        "last_updated": "2010-11-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "164W00000X",
            "taxonomy_group": "",
            "desc": "Licensed Practical Nurse",
            "state": "MO",
            "license": "055791",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "STATE BOARD OF NURSING LICENSE",
            "identifier": "055791",
            "state": "MO"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Jillian Rose Macdonald, PT
• Tauni Malmgren, OTD
• Robyn Nicole Malmsten, LP
• Radha Bala Manian, MS, RPH
• Latoya Martin, PHARM.D
• Sandra McCabe, RD
• Michael McConnell
• William McCracken, D.D.S
• Chelsea Soncearae McFadden, PHARMD
• David R McKee, FAMILY PRACTICE

• Licensed Practical Nurse in Chinle, AZ
• Providers in Chinle, AZ by specialty
• Licensed Practical Nurse in Arizona

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 30, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.