Gerise M. Martinez, RNFA

Individual provider Active NPI Registered Nurse First Assistant · Manteno, IL

NPI 1760623664 · NPPES record last updated Mar 23, 2009

Key facts

NPI
1760623664
Entity type
Individual (NPI type 1)
Primary specialty
Registered Nurse First Assistant 163WR0006X
License
041295350 (IL)
Practice address
8955 N 1000W Rd
Manteno, IL 60950-3587
Phone
(815) 468-3648
NPI assigned
Mar 23, 2009
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

State licenses

LicenseStateTypeSpecialty
041295350ILMDRegistered Nurse First Assistant

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Nurse First Assistant 163WR0006X 041295350 IL Yes

Addresses

Primary practice location

8955 N 1000W Rd
Manteno, IL 60950-3587

Mailing address

8955 N 1000W Rd
Manteno, IL 60950-3587
Phone (815) 468-3648

Other providers in Manteno, IL

All providers in Manteno, IL · Registered Nurse First Assistant in Illinois

Sources for this page

Verify at the official NPI Registry.