Basic Information
| Provider Information | |||||||||
| NPI: | 1811968597 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | MARTINEZ | ||||||||
| FirstName: | JANICE | ||||||||
| MiddleName: | ALISON | ||||||||
| NamePrefix: | |||||||||
| NameSuffix: | |||||||||
| Credential: | CNM | ||||||||
| OtherOrganizationName: | |||||||||
| OtherOrganizationType: | |||||||||
| OtherLastName: | BROWN | ||||||||
| OtherFirstName: | JANICE | ||||||||
| OtherMiddleName: | ALISON | ||||||||
| OtherNamePrefix: | |||||||||
| OtherNameSuffix: | |||||||||
| OtherCredential: | CNM | ||||||||
| OtherLastNameType: | 1 | ||||||||
| Mailing Information | |||||||||
| Address1: | PO BOX 1541 | ||||||||
| Address2: | |||||||||
| City: | OXFORD | ||||||||
| State: | NC | ||||||||
| PostalCode: | 275651541 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2524928576 | ||||||||
| FaxNumber: | 2524927464 | ||||||||
| Practice Location | |||||||||
| Address1: | 1209 SE INDUSTRY DR. | ||||||||
| Address2: | |||||||||
| City: | OXFORD | ||||||||
| State: | NC | ||||||||
| PostalCode: | 27565 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2524928576 | ||||||||
| FaxNumber: | 2524927464 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 01/30/2006 | ||||||||
| LastUpdateDate: | 04/29/2015 | ||||||||
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| NPIReactivationDate: | |||||||||
| ProviderGenderCode: | F | ||||||||
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| AuthorizedOfficialMiddleName: | |||||||||
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| IsSoleProprietor: | N | ||||||||
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| NPICertificationDate: | |||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 367A00000X | 366 | NC | Y | Physician Assistants & Advanced Practice Nursing Providers | Advanced Practice Midwife |
No ID Information.