Carissa Reanna Martinez, FNP
Nurse Practitioner in Boulder, CO. Individual provider (NPI-1).
NPI number1982126595
StatusActive
Last updated in NPPESJun 16, 2023
Details
- NPI
- 1982126595
- Entity type
- Individual (NPI-1)
- Name
- Carissa Reanna Martinez
- Credential
- FNP
- Sex
- Female
- Sole proprietor
- No
- Enumeration date
- Jul 14, 2017
- Certification date
- Jun 16, 2023
- Last updated
- Jun 16, 2023
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 363L00000X | Nurse Practitioner | 0993330-NP | CO | Yes |
| 163W00000X | Registered Nurse | 0200426 | CO | |
| 363LF0000X | Nurse Practitioner, Family | APN.0993330-NP | CO |
Other names
- Carissa Reanna Lopez (Former Name)
Practice location
4800 Baseline Rd Ste D106Boulder, CO 80303-2643
Phone 303-499-4800
Mailing address
4800 Baseline Rd Ste D106Boulder, CO 80303-2643
Phone 303-499-4800
Other practice locations
14300 Orchard Pkwy
Westminster, CO 80023-9206
Westminster, CO 80023-9206
Phone 720-627-3761
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