Provider Demographics
NPI:1407653793
Name:MARTI, CHARLES C
Entity type:Individual
Prefix:
First Name:CHARLES
Middle Name:C
Last Name:MARTI
Suffix:
Gender:
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7131 N 15TH ST
Mailing Address - Street 2:
Mailing Address - City:LINCOLN
Mailing Address - State:NE
Mailing Address - Zip Code:68521-9010
Mailing Address - Country:US
Mailing Address - Phone:402-890-9107
Mailing Address - Fax:
Practice Address - Street 1:7131 N 15TH ST
Practice Address - Street 2:
Practice Address - City:LINCOLN
Practice Address - State:NE
Practice Address - Zip Code:68521-9010
Practice Address - Country:US
Practice Address - Phone:402-890-9107
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-02-25
Last Update Date:2025-02-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes372600000XNursing Service Related ProvidersAdult Companion