Most Relevant Information
Provider Data
| NPI Number: | 1003599200 |
| Provider Name: | DIANE MARTIN RN |
| Entity Type: | Individual |
| Taxonomy Code: | 163WP2201X |
| Specialty: | Registered Nurse |
| License Number: | 0001229190 |
Most Important Dates
| Enumeration Date: | 08/14/2023 |
| Last Updated: | 08/14/2023 |
Provider Practice Location
8081 INNOVATION PARK DR. 5TH FLOOR
FAIRFAX
VA
22031
Practice Location Phone/Fax
| Phone: | 5714721646 |
| Fax: | 5714727037 |
Provider Mailing Location
8081 INNOVATION PARK DR. 5TH FLOOR
FAIRFAX
VA
22031
Provider Mailing Phone/Fax
| Phone: | 5714721646 |
| Fax: | 5714727037 |