Provider Demographics
NPI:1235952888
Name:MARTINEZ, JULIANNE (LM)
Entity type:Individual
Prefix:
First Name:JULIANNE
Middle Name:
Last Name:MARTINEZ
Suffix:
Gender:F
Credentials:LM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:406 S LEA AVE
Mailing Address - Street 2:
Mailing Address - City:ROSWELL
Mailing Address - State:NM
Mailing Address - Zip Code:88203-4564
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:575-616-7006
Practice Address - Street 1:406 S LEA AVE
Practice Address - Street 2:
Practice Address - City:ROSWELL
Practice Address - State:NM
Practice Address - Zip Code:88203-4564
Practice Address - Country:US
Practice Address - Phone:575-243-5001
Practice Address - Fax:575-616-7006
Is Sole Proprietor?:No
Enumeration Date:2024-11-04
Last Update Date:2024-11-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NM24004R175M00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes175M00000XOther Service ProvidersMidwife, Lay