Provider Demographics
NPI:1720814080
Name:MARTINEZ, GERALDINE DENISE (RN, BSM)
Entity type:Individual
Prefix:
First Name:GERALDINE
Middle Name:DENISE
Last Name:MARTINEZ
Suffix:
Gender:F
Credentials:RN, BSM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11885 S SAUNTER LN
Mailing Address - Street 2:
Mailing Address - City:PARKER
Mailing Address - State:CO
Mailing Address - Zip Code:80138-8866
Mailing Address - Country:US
Mailing Address - Phone:218-731-4322
Mailing Address - Fax:
Practice Address - Street 1:11885 S SAUNTER LN
Practice Address - Street 2:
Practice Address - City:PARKER
Practice Address - State:CO
Practice Address - Zip Code:80138-8866
Practice Address - Country:US
Practice Address - Phone:218-731-4322
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-09-12
Last Update Date:2024-09-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO0200335163WC0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WC0400XNursing Service ProvidersRegistered NurseCase Management