Provider Demographics
NPI:1447371778
Name:MARTIN, RHONDA KAY (ANP)
Entity type:Individual
Prefix:MS
First Name:RHONDA
Middle Name:KAY
Last Name:MARTIN
Suffix:
Gender:F
Credentials:ANP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:4485 BERMUDA AVE
Mailing Address - Street 2:
Mailing Address - City:SAN DIEGO
Mailing Address - State:CA
Mailing Address - Zip Code:92107-3926
Mailing Address - Country:US
Mailing Address - Phone:619-223-3743
Mailing Address - Fax:619-543-3781
Practice Address - Street 1:200 W ARBOR DR
Practice Address - Street 2:
Practice Address - City:SAN DIEGO
Practice Address - State:CA
Practice Address - Zip Code:92103-9001
Practice Address - Country:US
Practice Address - Phone:619-543-5871
Practice Address - Fax:619-543-3781
Is Sole Proprietor?:No
Enumeration Date:2007-04-03
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA325269363LA2100X, 364SA2100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Not Answered363LA2100XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAcute Care
Not Answered364SA2100XPhysician Assistants & Advanced Practice Nursing ProvidersClinical Nurse SpecialistAcute Care