Provider Demographics
NPI:1992211213
Name:MARTINEZ, AYLENE (FNP-C)
Entity type:Individual
Prefix:
First Name:AYLENE
Middle Name:
Last Name:MARTINEZ
Suffix:
Gender:F
Credentials:FNP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:630 HIGHWAY 71 W STE E
Mailing Address - Street 2:
Mailing Address - City:BASTROP
Mailing Address - State:TX
Mailing Address - Zip Code:78602-4283
Mailing Address - Country:US
Mailing Address - Phone:512-304-0313
Mailing Address - Fax:512-304-0326
Practice Address - Street 1:630 HIGHWAY 71 W STE E
Practice Address - Street 2:
Practice Address - City:BASTROP
Practice Address - State:TX
Practice Address - Zip Code:78602-4283
Practice Address - Country:US
Practice Address - Phone:512-304-0313
Practice Address - Fax:512-304-0326
Is Sole Proprietor?:No
Enumeration Date:2017-12-22
Last Update Date:2025-02-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXAP136037363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily