Provider Demographics
NPI:1023475142
Name:MARTIN, JEMIA DARICE (FNP)
Entity type:Individual
Prefix:MRS
First Name:JEMIA
Middle Name:DARICE
Last Name:MARTIN
Suffix:
Gender:F
Credentials:FNP
Other - Prefix:PROF
Other - First Name:JEMIA
Other - Middle Name:DARICE
Other - Last Name:MARTIN
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:FNP-BC, NP-C
Mailing Address - Street 1:9480 GATEWAY DR STE 100
Mailing Address - Street 2:
Mailing Address - City:RENO
Mailing Address - State:NV
Mailing Address - Zip Code:89521-3956
Mailing Address - Country:US
Mailing Address - Phone:775-788-7600
Mailing Address - Fax:775-827-3104
Practice Address - Street 1:9480 GATEWAY DR STE 100
Practice Address - Street 2:
Practice Address - City:RENO
Practice Address - State:NV
Practice Address - Zip Code:89521-3956
Practice Address - Country:US
Practice Address - Phone:775-788-7600
Practice Address - Fax:775-827-3104
Is Sole Proprietor?:Yes
Enumeration Date:2016-01-20
Last Update Date:2023-12-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NV812750363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily