Basic Information
| Provider Information | |||||||||
| NPI: | 1841494861 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | BATH | ||||||||
| FirstName: | MARTHA | ||||||||
| MiddleName: | JANE | ||||||||
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| Credential: | ARNP 9209019 | ||||||||
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| Mailing Information | |||||||||
| Address1: | 8708 40TH WAY | ||||||||
| Address2: | |||||||||
| City: | PINELLAS PARK | ||||||||
| State: | FL | ||||||||
| PostalCode: | 337825814 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7276672255 | ||||||||
| FaxNumber: | 7275775138 | ||||||||
| Practice Location | |||||||||
| Address1: | 8708 40TH WAY NORTH | ||||||||
| Address2: | |||||||||
| City: | PINELLAS PARK | ||||||||
| State: | FL | ||||||||
| PostalCode: | 33782 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7275443900 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 06/13/2007 | ||||||||
| LastUpdateDate: | 03/25/2011 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 163WW0101X | ARNP 9209019 | FL | Y | Nursing Service Providers | Registered Nurse | Women's Health Care, Ambulatory |
No ID Information.