Mary Allan F. Martinez, FNP

Individual provider Active NPI Nurse Practitioner · Norfolk, VA

NPI 1992783005 · NPPES record last updated Jul 8, 2007

Key facts

NPI
1992783005
Entity type
Individual (NPI type 1)
Primary specialty
Nurse Practitioner 363L00000X
License
0024083857 (VA)
Practice address
6333 Center Dr
BLDG. 16
Norfolk, VA 23502-4106
Phone
(757) 466-3429
Fax
(757) 466-1310
NPI assigned
Jan 9, 2006
Sex
Female
Sole proprietor
No

Organizations & group practices 3

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

Medicare participation

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

National Provider Directory

Medicare enrollment (NPD)
Yes
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
0024083857VAMDNurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Urology of Virginia, PC Past Accepting new patients
Urology of Virginia PC Past Accepting new patients
Urology of VA PC Past Accepting new patients

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X 0024083857 VA Yes

Addresses

Primary practice location

6333 Center Dr
BLDG. 16
Norfolk, VA 23502-4106

Mailing address

6333 Center Dr
BLDG. 16
Norfolk, VA 23502-4106
Phone (757) 466-3429

Other identifiers

IdentifierTypeStateIssuer
25560NOtherVASENTARA HEALTHCARE

Other providers in Norfolk, VA

All providers in Norfolk, VA · Nurse Practitioner in Virginia

Sources for this page

Verify at the official NPI Registry.