Tisha Raneil Martz, RN, BSN

Primary specialty

Registered NurseTaxonomy code 163W00000X

License

31871 Issued in WY

Practice address

501 S Burma Ave
Gillette, WY 82716-3426

Phone

(307) 688-5000

Fax

(307) 688-5015

NPI assigned

May 14, 2013

Sex

Female

Sole proprietor

No

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

Specialties & licenses 3

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Bachelor on Science - Nursing, Registered Nurse

State licenses

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

{
    "created_epoch": "1368489600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1370390400000",
    "number": "1487090726",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "820 WAGON TRAIL ST",
            "city": "GILLETTE",
            "state": "WY",
            "postal_code": "827185748",
            "telephone_number": "307-688-5000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "501 S BURMA AVE",
            "city": "GILLETTE",
            "state": "WY",
            "postal_code": "827163426",
            "telephone_number": "307-688-5000",
            "fax_number": "307-688-5015"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MARTZ",
        "first_name": "TISHA",
        "middle_name": "RANEIL",
        "credential": "RN, BSN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2013-05-14",
        "last_updated": "2013-06-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163WA0400X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Addiction (Substance Use Disorder)",
            "state": "WY",
            "license": "31871",
            "primary": false
        },
        {
            "code": "163WP0808X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Psychiatric/Mental Health",
            "state": "WY",
            "license": "31871",
            "primary": false
        },
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "WY",
            "license": "31871",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• John L. Mansell, M.D.
• Natasha W Maremma, MD
• J Joseph Marr III, MD
• Dustin Daryl Martinson, PT
• Heather Jean Martinson, PT
• Britney Matzick
• Morgan Taylor Maxwell
• Joseph C Maycock, O.D.
• Kirsten Kim Maycock, D.C.
• Paul Mayer, FNP

• Registered Nurse in Gillette, WY
• Providers in Gillette, WY by specialty
• Registered Nurse in Wyoming

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 5, 2013; 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.