Provider Demographics
NPI:1932062254
Name:MARTINEZ, STEPHANIE ROSAURA (PA)
Entity type:Individual
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First Name:STEPHANIE
Middle Name:ROSAURA
Last Name:MARTINEZ
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Gender:F
Credentials:PA
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Mailing Address - Street 1:2053 ANGEL FALLS DR
Mailing Address - Street 2:
Mailing Address - City:HENDERSON
Mailing Address - State:NV
Mailing Address - Zip Code:89074-4249
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:4060 N MARTIN L KING BLVD STE 101
Practice Address - Street 2:
Practice Address - City:NORTH LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89032-3213
Practice Address - Country:US
Practice Address - Phone:702-381-3989
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-12-04
Last Update Date:2025-12-04
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Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant