Evelyn Teresa Martin, RN

Primary specialty

Registered NurseTaxonomy code 163W00000X

License

041178086 Issued in IL

Practice address

309 Wabash Ave
Belleville, IL 62220-3843

Phone

(618) 806-8601

NPI assigned

Aug 11, 2016

Last updated

Aug 11, 2016By the provider in NPPES

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Other names 1

• Ms. Evelyn Teresa Mueth Martin Other name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Registered Nurse

State licenses

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

{
    "created_epoch": "1470873600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1470873600000",
    "number": "1932653698",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "309 WABASH AVE",
            "city": "BELLEVILLE",
            "state": "IL",
            "postal_code": "622203843",
            "telephone_number": "618-806-8601"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "309 WABASH AVE",
            "city": "BELLEVILLE",
            "state": "IL",
            "postal_code": "622203843",
            "telephone_number": "618-806-8601"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MARTIN",
        "first_name": "EVELYN",
        "middle_name": "TERESA",
        "name_prefix": "Ms.",
        "credential": "RN",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2016-08-11",
        "last_updated": "2016-08-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "IL",
            "license": "041178086",
            "primary": true
        },
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "MO",
            "license": "077284",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "EVELYN",
            "last_name": "MUETH MARTIN",
            "middle_name": "TERESA",
            "prefix": "MS.",
            "credential": "RN",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

• Eric Ray Marshall, RN
• Lauren Nicole Marshall, FNP
• Sheila Marshall, LPC
• Marshmallows Hope Nonprofit Organization Corp.
• Jamie Renee Martens, LCPC
• Jamaal Martin
• Jonah Daniel Martin, BCBA
• Megan Martin
• Marys Village Foundation
• Kayla Elizabeth Maschhoff, M.S., CCC-SLP

• Registered Nurse in Belleville, IL
• Providers in Belleville, IL by specialty
• Registered Nurse in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 11, 2016; 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.