Provider Demographics
NPI:1609180736
Name:MARTENS, CHERYL E (FNP)
Entity type:Individual
Prefix:MRS
First Name:CHERYL
Middle Name:E
Last Name:MARTENS
Suffix:
Gender:F
Credentials:FNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:1234 ANDERSON STREET
Mailing Address - Street 2:
Mailing Address - City:LOMA LINDA
Mailing Address - State:CA
Mailing Address - Zip Code:92354-6614
Mailing Address - Country:US
Mailing Address - Phone:909-558-4486
Mailing Address - Fax:212-746-8080
Practice Address - Street 1:1234 ANDERSON STREET
Practice Address - Street 2:
Practice Address - City:LOMA LINDA
Practice Address - State:CA
Practice Address - Zip Code:92354-6614
Practice Address - Country:US
Practice Address - Phone:909-558-4486
Practice Address - Fax:909-558-3168
Is Sole Proprietor?:No
Enumeration Date:2010-07-30
Last Update Date:2017-03-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CARN95045148163W00000X
CANP95001540363L00000X
NYF335477-1363LF0000X
NY542346-1363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No163W00000XNursing Service ProvidersRegistered Nurse
No363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner