Provider Demographics
NPI:1043036692
Name:MARTINEZ, AMABILIA EMILY (RN)
Entity type:Individual
Prefix:
First Name:AMABILIA
Middle Name:EMILY
Last Name:MARTINEZ
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:14516 DANCING HORSE TRL
Mailing Address - Street 2:
Mailing Address - City:HASLET
Mailing Address - State:TX
Mailing Address - Zip Code:76052-2717
Mailing Address - Country:US
Mailing Address - Phone:931-220-3155
Mailing Address - Fax:
Practice Address - Street 1:3412 FAIRVIEW ST
Practice Address - Street 2:
Practice Address - City:FORT WORTH
Practice Address - State:TX
Practice Address - Zip Code:76111-5312
Practice Address - Country:US
Practice Address - Phone:817-380-4331
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-11-27
Last Update Date:2024-11-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX937462163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse