Individual provider Active NPI

Nicole Martitsch-Kreiner, RN/ARNP

  • Medical-Surgical Registered Nurse
  • Boca Raton, FL
National Provider Identifier
1770226359
Registry record updated Apr 20, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Medical-Surgical Registered NurseTaxonomy code 163WM0705X
License
9295689 Issued in FL
Practice address
1905 Clint Moore Rd Ste 101
Boca Raton, FL 33496-2696
Phone
(561) 912-9191
Fax
(561) 372-0989
NPI assigned
Apr 20, 2022
Last updated
Apr 20, 2022By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 20, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Medical-Surgical Registered Nurse 163WM0705X 9295689 FL Primary

Addresses

Primary practice location

1905 Clint Moore Rd Ste 101
Boca Raton, FL 33496-2696

Mailing address

3310 NW 64TH St
Ft Lauderdale, FL 33309-1614
Phone (802) 236-7067

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
Credentials
Registered Nurse

State licenses

LicenseStateTypeSpecialty
9295689FLMDMedical-Surgical Registered Nurse

NPI Registry JSON

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

{
    "created_epoch": "1650412800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1650412800000",
    "number": "1770226359",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3310 NW 64TH ST",
            "city": "FT LAUDERDALE",
            "state": "FL",
            "postal_code": "333091614",
            "telephone_number": "802-236-7067"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1905 CLINT MOORE RD STE 101",
            "city": "BOCA RATON",
            "state": "FL",
            "postal_code": "334962696",
            "telephone_number": "561-912-9191",
            "fax_number": "561-372-0989"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MARTITSCH-KREINER",
        "first_name": "NICOLE",
        "credential": "RN/ARNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-04-20",
        "last_updated": "2022-04-20",
        "certification_date": "2022-04-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163WM0705X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Medical-Surgical",
            "state": "FL",
            "license": "9295689",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Boca Raton, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 20, 2022; 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.