Provider Demographics
NPI:1174921241
Name:MARTINEZ, STEPHANIE MELBA (MSPH, MHS, PA-C)
Entity type:Individual
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First Name:STEPHANIE
Middle Name:MELBA
Last Name:MARTINEZ
Suffix:
Gender:F
Credentials:MSPH, MHS, PA-C
Other - Prefix:
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Mailing Address - Street 1:4101 FIVE OAKS DR
Mailing Address - Street 2:UNIT 14
Mailing Address - City:DURHAM
Mailing Address - State:NC
Mailing Address - Zip Code:27707-5285
Mailing Address - Country:US
Mailing Address - Phone:407-489-9472
Mailing Address - Fax:
Practice Address - Street 1:1631 MIDTOWN PL STE 107
Practice Address - Street 2:
Practice Address - City:RALEIGH
Practice Address - State:NC
Practice Address - Zip Code:27609-1300
Practice Address - Country:US
Practice Address - Phone:919-876-1515
Practice Address - Fax:919-876-5656
Is Sole Proprietor?:No
Enumeration Date:2014-12-05
Last Update Date:2023-09-27
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
NC001005354363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant