Provider Demographics
NPI:1215939723
Name:MARTINI, SUZANNE ROSE (RN, MSN, FNP-C)
Entity type:Individual
Prefix:
First Name:SUZANNE
Middle Name:ROSE
Last Name:MARTINI
Suffix:
Gender:F
Credentials:RN, MSN, FNP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1010 S HUGHES RD
Mailing Address - Street 2:
Mailing Address - City:HOWELL
Mailing Address - State:MI
Mailing Address - Zip Code:48843-9123
Mailing Address - Country:US
Mailing Address - Phone:517-546-4938
Mailing Address - Fax:517-546-7314
Practice Address - Street 1:2310 E MICHIGAN AVE
Practice Address - Street 2:
Practice Address - City:LANSING
Practice Address - State:MI
Practice Address - Zip Code:48912-4018
Practice Address - Country:US
Practice Address - Phone:517-346-7628
Practice Address - Fax:517-346-7629
Is Sole Proprietor?:Not Answered
Enumeration Date:2005-08-15
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI4704124912363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily