Provider Demographics
NPI:1871575290
Name:STRONG, MARTHA ERIN (CPNP)
Entity type:Individual
Prefix:MRS
First Name:MARTHA
Middle Name:ERIN
Last Name:STRONG
Suffix:
Gender:F
Credentials:CPNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:420 N COIT RD
Mailing Address - Street 2:STE 2016
Mailing Address - City:RICHARDSON
Mailing Address - State:TX
Mailing Address - Zip Code:75080-5447
Mailing Address - Country:US
Mailing Address - Phone:972-664-1616
Mailing Address - Fax:972-664-1615
Practice Address - Street 1:420 N COIT RD
Practice Address - Street 2:STE 2016
Practice Address - City:RICHARDSON
Practice Address - State:TX
Practice Address - Zip Code:75080-5447
Practice Address - Country:US
Practice Address - Phone:972-664-1616
Practice Address - Fax:972-664-1615
Is Sole Proprietor?:No
Enumeration Date:2005-11-20
Last Update Date:2014-03-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX625371363LP0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX138973618Medicaid
TX138973614Medicaid
TX138973617Medicaid
TX138973614Medicaid