Most Relevant Information
Provider Data
| NPI Number: | 1003019308 |
| Provider Name: | JACQUELINE MARTINEZ |
| Entity Type: | Individual |
| Taxonomy Code: | 164W00000X |
| Specialty: | Licensed Practical Nurse |
| License Number: | PN275398 |
Most Important Dates
| Enumeration Date: | 06/06/2007 |
| Last Updated: | 07/08/2007 |
Provider Practice Location
501 MARKET ST
LEWISBURG
PA
178373002
Practice Location Phone/Fax
| Phone: | 5705240900 |
| Fax: |
Provider Mailing Location
221 N 4TH ST
SUNBURY
PA
178011921
Provider Mailing Phone/Fax
| Phone: | |
| Fax: |