Provider Demographics
NPI:1699782169
Name:MARTI, JANET L (CNP)
Entity type:Individual
Prefix:
First Name:JANET
Middle Name:L
Last Name:MARTI
Suffix:
Gender:F
Credentials:CNP
Other - Prefix:
Other - First Name:JANET
Other - Middle Name:L
Other - Last Name:MEYER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:CNP
Mailing Address - Street 1:1100 E. BROADWAY
Mailing Address - Street 2:AFFILIATED COMMUNITY MEDICAL CENTERS
Mailing Address - City:REDWOOD FALLS
Mailing Address - State:MN
Mailing Address - Zip Code:56283
Mailing Address - Country:US
Mailing Address - Phone:507-637-2985
Mailing Address - Fax:507-637-3057
Practice Address - Street 1:1100 E. BROADWAY
Practice Address - Street 2:AFFILIATED COMMUNITY MEDICAL CENTERS
Practice Address - City:REDWOOD FALLS
Practice Address - State:MN
Practice Address - Zip Code:56283
Practice Address - Country:US
Practice Address - Phone:507-637-2985
Practice Address - Fax:507-637-3057
Is Sole Proprietor?:No
Enumeration Date:2006-08-01
Last Update Date:2008-08-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MNR087475-7363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
MN500003124Medicare PIN
MNP00276232Medicare PIN