Provider Demographics
NPI:1871714691
Name:STAPLE, MARTA L (APNP, RN)
Entity type:Individual
Prefix:
First Name:MARTA
Middle Name:L
Last Name:STAPLE
Suffix:
Gender:F
Credentials:APNP, RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:202 S. PARK ST
Mailing Address - Street 2:
Mailing Address - City:MADISON
Mailing Address - State:WI
Mailing Address - Zip Code:53715-1596
Mailing Address - Country:US
Mailing Address - Phone:608-417-6000
Mailing Address - Fax:608-417-3878
Practice Address - Street 1:345 W WASHINGTON AVE STE 100
Practice Address - Street 2:
Practice Address - City:MADISON
Practice Address - State:WI
Practice Address - Zip Code:53703-3050
Practice Address - Country:US
Practice Address - Phone:608-417-8300
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-05-01
Last Update Date:2013-10-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA686376163WW0101X
CA17019363LW0102X
WI3413-33363LW0102X, 363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
No163WW0101XNursing Service ProvidersRegistered NurseWomen's Health Care, Ambulatory
No363LW0102XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerWomen's Health