Mary Eloise Martin, RN,BSN

Primary specialty

Medical-Surgical Registered NurseTaxonomy code 163WM0705X

License

909730 Issued in TX

Practice address

516 E Nizhoni Blvd
Gallup, NM 87301-5748

Phone

(505) 722-1000

NPI assigned

Aug 26, 2020

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

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": "1598400000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1598400000000",
    "number": "1669085957",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "490 FARM ROAD 1735",
            "city": "MOUNT PLEASANT",
            "state": "TX",
            "postal_code": "754558250",
            "telephone_number": "903-563-4167"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "516 E NIZHONI BLVD",
            "city": "GALLUP",
            "state": "NM",
            "postal_code": "873015748",
            "telephone_number": "505-722-1000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MARTIN",
        "first_name": "MARY",
        "middle_name": "ELOISE",
        "name_prefix": "Mrs.",
        "credential": "RN,BSN",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2020-08-26",
        "last_updated": "2020-08-26",
        "certification_date": "2020-08-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163WM0705X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Medical-Surgical",
            "state": "TX",
            "license": "909730",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Erica Marie Marquez, NP-C
• Calvin Marshall
• Alainna Ruth Martin, RN
• Annette Martin
• Charlotte Martin, RN
• Danielle Martinez
• Danielle Rae Martinez
• Deanna C Martinez
• Diserae Martinez, RN
• Hope Juno Martinez, LMHC

• Medical-Surgical Registered Nurse in Gallup, NM
• Providers in Gallup, NM by specialty
• Medical-Surgical Registered Nurse in New Mexico

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 26, 2020; 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.